Rural-urban differences in home-based care willingness among older adults: A cross-sectional study in Shandong, China

Int J Qual Health Care. 2020 Apr 27;32(2):126-134. doi: 10.1093/intqhc/mzz132.

Abstract

Objective: To examine the rural-urban disparities of home-based care willingness among older adults and identify the influencing factors.

Design: A cross-sectional study.

Setting: The data used in this cross-sectional study were conducted in Shandong province.

Study participants: 7070 older adults (60 years and older) with complete data were included in this analysis from the 2017 Survey of the Shandong Elderly Family Health Service.

Intervention: N/A.

Main outcome measure: The data were analyzed using logistic regression models to examine whether socio-demographic characteristic, physical health, loneliness score and other factors were associated with home-based care willingness in rural and urban older adults. After exploring the factors, we compared the difference.

Results: Of 7070 participants, 66.9% were rural older adults and 33.1% were urban. The urban older adults less likely chose home-based care than the rural (OR = 0.667; P < 0.05). Binary logistic regression analysis showed that age (P < 0.05), income (P < 0.05), current employment (P < 0.05) and loneliness (P < 0.05) were significantly associated with the home-based care willingness both in rural and urban residence. Besides, the number of family members (P = 0.010), education years (P = 0.026) and financial support from children (P = 0.017) were associated factors of rural respondents' home-based care willingness. The bad self-reported-health-status-urban-older adults (P = 0.026) were more willing for home-based care.

Conclusions: The research we have done suggests that there is a residence difference toward home-based care willingness among older adults. Targeted policies and an age-friendly environment should be made for different subgroups of older adults.

Keywords: home-based care willingness; older adults; rural–urban difference.

MeSH terms

  • Aged
  • Aged, 80 and over
  • China
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Home Care Services*
  • Humans
  • Loneliness
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Rural Population*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Urban Population*