Undermet Needs for Assistance in Personal Activities of Daily Living Among Community-Dwelling Oldest Old in China From 2005 to 2008

Peng, Renjun; Wu, Bei; Li, Ling

doi:10.1177/0164027514524257

Cited by 36 publications

(54 citation statements)

References 56 publications

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“…A number of studies have supported this positive relationship between economic status and formal care [10, 28], and it likely reflects an income-related inequity of unmet care needs. For example, two studies in China showed that the risk of having unmet needs was largely determined by elderly adults’ financial status [29, 30]. In the present study, the rate of formal care use in the highest income group was significantly greater than that in the lowest income group, even when they had the same ADL scores.…”

Section: Discussioncontrasting

confidence: 42%

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Fang

Gao

et al. 2017

PLoS ONE

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The need for formal care among the elderly population has been increasing due to their greater longevity and the evolution of family structure. We examined the determinants of the use and expenses of formal care among in-home elderly adults in Shanghai. A two-part model based on the data from the Shanghai Long-Term Care Needs Assessment Questionnaire was applied. A total of 8428 participants responded in 2014 and 7100 were followed up in 2015. The determinants of the probability of using formal care were analyzed in the first part of the model and the determinants of formal care expenses were analyzed in the second part. Demographic indicators, living arrangements, physical health status, and care type in 2014 were selected as independent variables. We found that individuals of older age; women; those with higher Activities of Daily Living (ADL) scores; those without spouse; those with higher income; those suffering from stroke, dementia, lower limb fracture, or advanced tumor; and those with previous experience of formal and informal care were more likely to receive formal care in 2015. Furthermore, age, income and formal care fee in 2014 were significant predictors of formal care expenses in 2015. Taken together, the results showed that formal care provision in Shanghai was not determined by ADL scores, but was instead more related to income. This implied an inappropriate distribution of formal care among elderly population in Shanghai. Additionally, it appeared difficult for the elderly to quit the formal care once they begun to use it. These results highlighted the importance of assessing the need for formal care, and suggested that the government offer guidance on formal care use for the elderly.

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Section: Discussioncontrasting

confidence: 42%

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Fang

Gao

et al. 2017

PLoS ONE

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“…The results of this study indicated that the willingness of caregivers and economic status were significantly important for both urban and rural residents, similar to the prior studies [3,8,25]. Regardless of the caregiver's identity, the willingness of caregivers to provide care is the most influential factor with the largest OR changes.…”

Section: Rural-urban Differences In the Influencing Factors Of Unmet supporting

confidence: 83%

Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China

Zeng

Wang

Zhang

et al. 2019

Preprint

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Background: Estimates of unmet needs, as an indicator of future needs for long-term care (LTC) services, have become increasingly crucial policy concerns. This study aimed to examine the urban-rural differences in unmet needs and the demand for community care service among community-dwelling elderly people in China. Methods: The data come from the 2014 Chinese Longitudinal Health Longevity Survey (CLHLS). A total of 1587 community residents aged 65+ with disabilities in the activities of daily living (ADLs) were included in this study. Based on the Andersen theoretical model, binary logistic regression was used to estimate the correlates of unmet needs in LTC. A chi-square test was used to examine the differences in expected needs for community-based LTC services between urban and rural areas. Results: Over half (55.07%) of the participants reported their needs were unmet. Poor economic status and reluctant caregivers seriously affected elderly unmet needs. Among urban older adults, those who were male and lonely reported more unmet needs. Among rural ones, those with severe ADL disability and poor self-rated health reported more unmet needs. In addition, access to medication and home visit services were negatively associated with unmet needs. Living with children (69.12%) was viewed as the most desirable living arrangement among older adults, while living in a LTC facility seemed to be more accepted for rural residents with unmet needs than for other elderly respondents. Residents showed a high demand for community LTC care services, with 82.55% of them expecting to need home visits and 74.29% to healthcare education. Specifically, rural residents had greater expected needs for every community care service than their urban counterparts. However, only 4.66% to 36.42% of the respondents reported that all eight types of services were available, which was far below the demand for these services. Conclusion: The risk of having unmet LTC needs is largely determined by elderly people’s economic status and caregivers’ willingness to provide care for both rural and urban elderly residents. More attention should be paid to psychological consulting services in urban areas, as well as personal care, home visits, psychological consulting and healthcare education services in rural areas.

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“…A 2008CLHLS report showed that around one fourth of the Chinese oldest old, 28% in rural and 22% in urban areas, had needs for assistance in personal activities during daily living which were not met (Peng et al, 2015). In view of the distinctiveness of China’s culture, demographic structure, and other associated socioeconomical concerns, it is likely that establishment of a home care-dominated, supported by community care, and supplemented with institutional care (such as nursing home) as well as other alternatives may help to meet the escalating burden of the aging society (Liu et al, 2015).…”

Section: To Establish An Aging Friendly Societymentioning

confidence: 99%

A research agenda for aging in China in the 21st century

Fang

Scheibye‐Knudsen

Jahn

et al. 2015

Ageing Research Reviews

Self Cite

432

353

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China is encountering formidable healthcare challenges brought about by the problem of aging. By 2050, there will be 400 million Chinese citizens aged 65+, 150 million of whom will be 80+. The undesirable consequences of the one-child policy, rural-to-urban migration, and expansion of the population of ‘empty nest ’ elders are eroding the traditional family care of the elders, further exacerbating the burden borne by the current public healthcare system. The challenges of geriatric care demand prompt attention by proposing strategies for improvement in several key areas. Major diseases of the elderly that need more attention include chronic non-communicable diseases and mental health disorders. We suggest the establishment of a home care-dominated geriatric care system, and a proactive role for researchers on aging in reforming geriatric care through policy dialogs. We propose ideas for preparation of the impending aging burden and the creation of a nurturing environment conducive to healthy aging in China.

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Undermet Needs for Assistance in Personal Activities of Daily Living Among Community-Dwelling Oldest Old in China From 2005 to 2008

Cited by 36 publications

References 56 publications

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Rural-urban disparities in unmet long-term care needs and the demand for community care services among elderly people in China

A research agenda for aging in China in the 21st century

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