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

Abstract

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.