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Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

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  • Liangwen Zhang

    (State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
    Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen 361102, China
    School of Economics, Xiamen University, 422 Siming South Road, Xiamen 361006, China)

  • Yanbing Zeng

    (State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
    Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen 361102, China)

  • Lixia Wang

    (State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
    Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen 361102, China)

  • Ya Fang

    (State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
    Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen 361102, China)

Abstract

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees ( p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

Suggested Citation

  • Liangwen Zhang & Yanbing Zeng & Lixia Wang & Ya Fang, 2020. "Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China," IJERPH, MDPI, vol. 17(5), pages 1-18, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:5:p:1701-:d:328797
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    1. Run-Ping Che & Mei-Chun Cheung, 2022. "Community-Dwelling Older Adults’ Intended Use of Different Types of Long-Term Care in China and Its Associated Factors Based on the Andersen Behavioral Model," IJERPH, MDPI, vol. 19(18), pages 1-16, September.
    2. Nazarudin Safian & Shamsul Azhar Shah & Juliana Mansor & Zulkefley Mohammad & Siti Rohani Nurumal & Wan Abdul Hannan Wan Ibadullah & Saharuddin Ahmad & Yugo Shobugawa, 2021. "Factors Associated with the Need for Assistance among the Elderly in Malaysia," IJERPH, MDPI, vol. 18(2), pages 1-14, January.

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