Pathways to Improve Provision of Home and Community-Based Services-A Configurational Approach Based on a Fuzzy-Set Qualitative Comparative Analysis From China

J Appl Gerontol. 2024 Jan;43(1):89-100. doi: 10.1177/07334648231197029. Epub 2023 Nov 1.

Abstract

Providing home and community-based services (HCBS) is critical for active and healthy aging. However, in China, the positive factors for improving HCBS provision are unclear, limiting its contribution to improving older adults' quality of life and promoting active and healthy aging. Therefore, this study examines the configurations that produce differences in HCBS and identifies multiple pathways for improving them and narrowing regional disparities. Using data from multiple datasets comprising 23 cases, we performed configuration analysis using fuzzy-set qualitative comparative analysis. Four pathways producing high HCBS provision and three pathways producing low HCBS provision were found. Different combinations of the aging population, economic development, institutional support, financial support, and development of multiple stakeholders influence HCBS provision. Thus, measures based on the main factor characteristics should be implemented to improve the HCBS provision level.

Keywords: configurational approach; fuzzy-set qualitative comparative analysis; home and community-based services; provision.

MeSH terms

  • Aged
  • Community Health Services*
  • Home Care Services*
  • Humans
  • Medicaid
  • Quality of Life
  • Social Welfare
  • United States