Abstract
This study investigates the characteristics of Chinese older people receiving home and community care and the factors associated with the sources of payment for care services. The data come from the Social Survey of Older People in Urban China, which collected information from a random sample of 3,247 older people aged 60 and over in 10 large cities in different regions of China in 2017. Anderson's behavioural model of care utilisation is used to guide the analyses. The study identifies four striking features of the Chinese social care system. First, although disabilities are a significant predictor of receiving home and community care, a large proportion of care recipients do not have disabilities. Second, perceived proximity of care is the most important predictor, which implies high elasticity of demand for care services with regard to perceived distance and the great geographical inequality of care resources in the cities. Third, the government policies support the use of the internet to facilitate care access, but the enabling effect of the internet among older people is limited. Finally, sources of payment for care differ significantly according to people's age, living arrangements, disability and level of education. We argue that the government should consider shifting the focus of financial support from service providers to care recipients in the future.
Original language | English |
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Pages (from-to) | 225-235 |
Number of pages | 11 |
Journal | Health and Social Care in the Community |
Volume | 28 |
Issue number | 1 |
Early online date | 1 Dec 2019 |
DOIs | |
Publication status | Published - Jan 2020 |
Externally published | Yes |
Funding
Receipt of care is more strongly driven by perceived proximity of care than care needs in urban China. Use of the internet does not automatically lead to the use of home and community care; it only facilitates care access for a small group of older people with the ‘right’ level of IT skills. Due to the stringent eligibility criteria for government support, a small proportion of older people receive publicly funded care, whereas most people must pay for care themselves or rely on financial support from relatives.
Keywords
- China
- home and community care
- older people
- payment of care
- service use