Utilisation of home-/community-based care services: current experience and future intention in urban China

The provision of home-/community-based care (HCBC) services for elderly people has become an increasingly popular form of aged care in many aging societies. To tackle the challenges of aged care caused by dramatic population aging, China is developing its HCBC provision system to relieve the public financial burden and cater for the traditional preference for aging at home. Using the database of the China Longitudinal Aging Social Survey (CLASS), this study examines how elderly people utilize HCBC and which factors correlate with their utilization in urban China. The results indicate that elderly people with experience of HCBC services accounted for a relatively small proportion (8.47%) of the total elderly population in urban China in 2014, yet the future utilization intention rate was higher, at 13.27%. Based on a research framework applying institutional theory and welfare pluralism theory, the study also investigates the correlations between individual characteristics, family, and social support and aged care arrangements, demonstrating that factors at both individual and institutional levels are significantly associated with the utilization of HCBC services. In particular, elderly people with insufficient financial support from children and social support are less likely to utilize HCBC services, while those who are son-less and have no emotional support from children are more likely to use HCBC. The results reveal an unmet demand for HCBC services in contemporary China and the notable influence of familial and societal bonding on HCBC utilization among the elderly Chinese population. Corresponding explanations are provided, and policy implications are suggested.