Association of Sensory Impairment With Institutional Care Willingness Among Older Adults in Urban and Rural China: An Observational Study

Shimin Zhang; Qiong Wang; Dan Zhao; Peipei Fu; Kaili Qi; Xiyuan Wang; Yanxin Zhou; Peilong Li; Jingjie Sun; Chengchao Zhou

doi:10.1093/geroni/igad013

Association of Sensory Impairment With Institutional Care Willingness Among Older Adults in Urban and Rural China: An Observational Study

Innov Aging. 2023 Feb 21;7(3):igad013. doi: 10.1093/geroni/igad013. eCollection 2023.

Authors

Shimin Zhang^{1

2}, Qiong Wang^{1

2}, Dan Zhao^{1

2}, Peipei Fu^{1

2}, Kaili Qi^{1

2}, Xiyuan Wang^{1

2}, Yanxin Zhou^{1

2}, Peilong Li³, Jingjie Sun³, Chengchao Zhou^{1

2

4}

Affiliations

¹ Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
² NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
³ Shandong Health Commission Medical Management Service Center, Jinan, China.
⁴ Institute of Health and Elderly Care, Shandong University, Jinan, China.

Abstract

Background and objectives: An aging population has contributed to increasing rates of sensory impairment (SI) among older adults and a boom in institutional elder care. However, little is known regarding the association between SI and institutional care willingness. This study identified the association between SI and institutional care willingness among older adults living both in urban and rural China.

Research design and methods: This was an observational study using the sixth National Health Service Survey of Shandong Province, China, in 2018. A total of 8 583 individuals aged ≥60 years were included. The primary outcome was institutional care willingness. Self-reported SI was categorized as vision impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI). We used multivariable logistic regression models to estimate the association between SI and institutional care willingness, stratified by the place of residence.

Results: The overall proportion of older adults with institutional care willingness was 7.8%. In fully adjusted models, older adults with HI only (odds ratio [OR] = 1.57, 95% confidence interval [CI]: 1.12-2.20) or DSI (OR = 1.68, 95% CI: 1.14-2.49) were more likely to show institutional care willingness than those without SI in urban areas, but no significant associations between VI only (OR = 0.95, 95% CI: 0.68-1.31), HI only (OR = 0.99, 95% CI: 0.73-1.34), or DSI (OR = 0.95, 95% CI: 0.68-1.31) and institutional care willingness were observed among rural older adults.

Discussion and implications: Our results underscore that the relationship between SI and institutional care willingness varied by place of residence, and provide a reference for making targeted and appropriate endowment policies. Improving the quality of institutional elder care is vital for urban older adults with SI, whereas community-based care might be more appropriate for rural older adults with SI.

Keywords: Dual sensory impairment; Hearing impairment; Long-term care; Vision impairment.