The demand for elderly care services and anticipated living arrangements among the oldest-old in China based on the Andersen model

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> In China, the issues arising from an aging population are becoming increasingly serious, so research on elderly health has become a topic of discussion. However, few studies have focused on the oldest-old with regards to their existing demand for elderly care services and anticipated living arrangements. <jats:bold>Methods:</jats:bold> The data of 4738 participants aged ≥80 years were extracted from the Chinese Longitudinal Health Longevity Survey (CLHLS) carried out in 2014. Using the Andersen model as the analysis framework, a multiple logistic regression was used to analyze the relationship between anticipated use of social services and intended residence and influencing factors. Odds ratios (ORs) were calculated to indicate the relationship between the influencing factors and the dependent variables.<jats:bold>Results: </jats:bold>From the descriptive analysis results, it is found that oldest-old showed high anticipated needs for care services, such as home visits (83.5%), health education (76.4%). And there exists a huge imbalance between supply and demand for aged care services. Moreover, living with children is still the most important way of providing for the oldest-old (44.4% in urban, 55.6% in rural). The multivariate regression results showed that the demand for elderly care services and anticipated living arrangements among the oldest-old in China are influenced by predisposing factors, enabling factors, and need factors (P&lt;0.05). The oldest-old who are older, without housing property rights, childless, and ADL-restricted are more tend to live in long-term care institutions (ORs&gt;1, P&lt;0.05).<jats:bold> </jats:bold><jats:bold>Conclusions: </jats:bold>The most vital needs of the oldest-old are home visits, health education, and spiritual comfort. There is a huge imbalance between supply and demand. Moreover, living with children is still the most important way of providing for the oldest-old. Demand for elderly care services and anticipated living arrangements are influenced by predisposing, enabling and need factors. Although the family plays an essential role in the healthcare of the oldest-old, the traditional pension model no longer meets the multi-level and diversified healthcare service needs of the oldest-old due to the rapidly aging Chinese population, which requires countermeasures from policy makers.</jats:p>