Abstract
This study examined the factors related to the use of home and community based services (HCBS) by urban Chinese older adults with disabilities. The study used data from the 2006 Sample Survey on Aged Population in Urban/Rural China. A total of 3,920 older adults who experienced at least one disability were included in this sample. Of the study participants, 13.9% used housekeeping services and 12.2% used doctor/nurse home visit services. Results from logistic regression tests showed that older adults’ gender, educational attainment, financial strain, family support, and number of chronic illnesses were significantly related to their use of housekeeping services. Additionally, older adults’ levels of disability were significantly related to doctor/nurse home visit services. Findings underscore the importance of service needs in Chinese older adults’ use of HCBS and also reveal that factors related to service use vary depending on specific services.
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References
Andersen, R. M. (1995). Revising the behavioral model and access to medical access: Does it matter? Journal of Health and Social Behavior, 36, 1–10.
Bass, D. M., & Noelker, L. S. (1987). The influence of family caregivers on elder’s use of in-home services: An expanded conceptual framework. Journal of Health and Social Behavior, 28, 184–196.
Boey, K. W. (2000). The use of GDS-15 among the older adults in Beijing. Clinical Gerontologist, 21, 49–60. https://doi.org/10.1300/J018v21n02_05
Chan, C. L. W., Yip, P. S. F., Ng, E. H. Y., Ho, P. C., & Au, J. S. K. (2002). Gender selection in China: Its meaning and implications. Journal of Assisted Reproduction and Genetics, 19, 426–430. https://doi.org/10.1023/A:1016815807703
Chen, H., Chi, I., & Liu, R. (2019). Hospital utilization among Chinese older adults: Patterns and predictors. Journal of Aging and Health, 31, 1454–1478. https://doi.org/10.1177/0898264318780546
Cheng, S.-T., & Chan, A. C. M. (2006). Filial piety and psychological well-being in well older Chinese. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 61, P262–P269. https://doi.org/10.1093/geronb/61.5.P262
China Research Center on Aging. (2007). 2006 Sample Survey on Aged Population in Urban/Rural China technical report. Author.
Chou, K.-L., & Chi, I. (2001). Selection, optimization, and compensation questionnaire: A validation study with Chinese older adults. Clinical Gerontologist, 24, 141–151. https://doi.org/10.1300/J018v24n01_10
Chou, R. J.-A. (2010). Perceived need and actual usage of the family support agreement in rural China: Results from a nationally representative survey. Gerontologist, 51, 295–309. https://doi.org/10.1093/geront/gnq062
Enders, C. K. (2010). Applied missing data analysis. Guilford Press.
Feng, Z., Liu, C., Guan, X., & Mor, V. (2012). China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Affairs, 31, 2764–2773. https://doi.org/10.1377/hlthaff.2012.0535
Gong, C. H., Kendig, H., & He, X. (2016). Factors predicting health services use among older people in China: An analysis of China Health and Retirement Longitudinal Study 2013. BMC Health Services Research, 16, 63. https://doi.org/10.1186/s12913-016-1307-8
Hair, J. F. (1998). Multivariate data analysis (5th ed.). Prentice Hall.
He, W., Sengupta, M., Zhang, K., & Guo, P. (2007). Health and health care of the older population in urban and rural China: 2000 (International Population Report No. P95/07-2). Washington, DC: U.S. Census Bureau.
Hong, S. I. (2010). Understanding patterns of service utilization among information caregivers of community older adults. Gerontologist, 50, 87–99. https://doi.org/10.1093/geront/gnp105
Lan, P. C. (2002). Subcontracting filial piety: Elder care in ethnic Chinese immigrant families in California. Journal of Family Issues, 23, 812–835. https://doi.org/10.1177/019251302236596
Li, Y., & Chi, I. (2011). Correlates of physician visits among older adults in China: The effects of family support. Journal of Aging and Health, 23, 933–953. https://doi.org/10.1177/0898264311401390
Li, Y., Xu, L., Chi, I., & Guo, P. (2014). Participation in productive activities and health outcomes among older adults in urban China. Gerontologist, 54, 784–796. https://doi.org/10.1093/geront/gnt106
Liu, X., & Wong, H. (2016). The reform of the medical welfare system and health equity for the elderly in China: A study in Zhejiang. Journal of Chinese Sociology, 3, 6.
Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J. C., & Stuck, A. E. (2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist, 46, 503–513. https://doi.org/10.1093/geront/46.4.503
Miller, B., & McFall, S. (1992). Caregiver burden and the continuum of care: A longitudinal perspective. Research on Aging, 14, 376–398.
Ministry of Civil Affairs of People's Republic of China. (2015, June 10). 2014 statistical report on civil affair development [In Chinese]. http://www.mca.gov.cn/article/sj/tjgb/201506/201506158324399.shtml
Mitchell, J., & Krout, J. A. (1998). Discretion and service use among older adults: The behavioral model revisited. Gerontologist, 38, 159–168. https://doi.org/10.1093/geront/38.2.159
Sonnega, A., Robinson, K., & Levy, H. (2016). Home and community-based service and other senior service use: Prevalence and characteristics in a national sample. Home health care services quarterly, 36(1), 16–28. https://doi.org/10.1080/01621424.2016.1268552
Tia, Q. H., & Meng, C. H. (2012). The examination of community service needs experienced by urban, empty-nest older adults [In Chinese]. Journal of Nanjing College Population Program Management, 28, 30–68.
Toseland, R. W., McCallion, P., Gerber, T., & Banks, S. (2002). Predictors of health and human services use by persons with dementia and their family caregivers. Social Science & Medicine, 55, 1255–1266. https://doi.org/10.1016/S0277-9536(01)00240-4
United Nations. Department of Economic and Social Affairs, Population Division. (2015). World population ageing 2015 (ST/ESA/SER.A/390). Retrieved from http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Highlights.pdf
Wang, C. W., Chan, C. L. W., Ho, A. H. Y., & Xiong, Z. (2008). Social networks and health-related quality of life among Chinese older adults with vision impairment. Journal of Aging and Health, 20, 804–823. https://doi.org/10.1177/0898264308321083
Wang, L. L. (2013). Studies on older adults’ needs for and use of community services and availability of such services in communities, using the theory of service chain [In Chinese]. Population Journal, 35, 49–59.
Wang, M. (2007). Emerging urban poverty and effects of the Dibao program on alleviating poverty in China. China & World Economy, 15, 74–88.
Wang, Q. (2016). Demands and determinants of community home-based care services for urban elderly: Based on the 2010 National Elderly Survey in China. Population Research, 1, 98–112.
Zhan, H. J., Feng, X., & Luo, B. (2008). Placing elderly parents in institutions in urban China: A reinterpretation of filial piety. Research on Aging, 30, 543–571. https://doi.org/10.1177/0164027508319471
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Li, H., Xu, L., Chi, I. et al. Use of Home and Community Based Services in Urban China: Experiences of Older Adults with Disabilities. J Cross Cult Gerontol 37, 115–126 (2022). https://doi.org/10.1007/s10823-021-09444-w
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DOI: https://doi.org/10.1007/s10823-021-09444-w