Spatial justice in the Silver Economy: determinants and spillover effects of elderly care resources in China

To address regional disparities in China’s emerging “Silver Economy,” this study investigates the spatial determinants of elderly care resources. Applying a Spatial Durbin Model (SDM) to 2022 cross-sectional data from 285 prefecture-level cities, we analyze the distribution of institutional care facilities and bed capacity. The analysis yields three key findings. First, an “Economic Capacity Paradox” exists: while local household disposable income stimulates care supply, high urban per capita GDP exerts a negative crowding-out effect due to escalating operational costs. Second, demographic demand—specifically the local elderly population ratio—acts as the primary driver of resource allocation. Third, spatial spillover analysis reveals a significant “Siphon Effect”, whereby core cities draw capital and skilled care labor away from neighboring municipalities, exacerbating spatial inequalities. To achieve spatial justice, policymakers must move beyond aggregate supply targets and implement cross-regional coordination mechanisms alongside targeted cost-offset subsidies in high-tier cities.