Peer effects on older adults' preferences for formal long-term care in China

Objective To examine the impact of the peer effects on the preferences of the older-aged Chinese for formal long-term care (LTC) services. Methods During July-August 2022, the study conducted a randomized controlled experiment using a survey design. Respondents aged 50–70, were randomly assigned to a control group and a peer effect group, where the peer group was divided into Peer 1 not having friends and relatives receiving LTC and Peer 2 having relatives and friends receiving LTC. Data included personal socioeconomic-demographic information, LTC service needs, and willingness to accept formal LTC. Statistical analysis was performed using descriptive statistics, logistic regressions, and heterogeneity analysis. Results Compared to the control group, the peer effect groups showed a statistically significant increase of 20.06% in the proportion of elderly individuals opting for formal LTC. The study found that willingness to accept formal long-term care services increased with the peer effect intervention, and Peer 2, with family and friends receiving LTC, had a larger uptake of LTC than Peer 1 with no family and friends receiving LTC. Statistical analysis confirmed significant differences between the control, Peer 1 and Peer 2 groups. In terms of peer effects interventions, older people with high incomes and unsure about their future risks of developing a chronic disease were more likely to opt for formal LTC. Heterogeneity analysis of the peer effects group revealed that sex, age, marital status, residential location, educational level, monthly income, number of children, presence of chronic diseases, and risk of chronic diseases, significantly influenced the willingness to accept LTC services within the two peer groups. Conclusion The findings suggest that peer effects played a critical role in shaping the preferences of older aged Chinese for formal LTC services. The study highlights the need for strategies to utilize peer influences, as well as socioeconomic and demographic factors, in policy-making and communicating strategies to enhance acceptance of LTC services among China’s older-aged population. Tailored interventions and information dissemination that leverage peer networks and address varied socioeconomic-demographic needs are crucial for effective LTC policy and service implementation.