Willingness to receive institutional and community-based eldercare among the rural elderly in China

Studies on the willingness to receive institutional eldercare among the rural elderly are scarce. This study aims to explore factors associated with the willingness to receive institutional eldercare and community-based eldercare among the rural elderly. A cross-sectional study was conducted in three rural villages of Changde City, Hunan Province, China. A total of 517 elderly were recruited through multistage sampling from these villages. The dependent variable is the willingness to receive eldercare from family (as reference), institution, and community. The independent variables includes sociodemographic characteristics: having physical disease, depression, anxiety, and daily living activities, and concerns toward home-based, institutional, and community-based care, respectively. Results show that 78.3% of the elderly are willing to receive home-based eldercare, 10.8% institutional eldercare, and 8.5% community-based eldercare. The factors associated with the willingness to receive institutional eldercare are having concerns toward home-based (OR = 4.85, P<0.001) and institutional eldercare (OR = 5.51, P<0.001). The factors associated with community-based care is living alone (OR = 2.18, P = 0.034). Finally, the major concerns toward home-based eldercare are lack of care ability and separation of family members, whereas those toward institutional eldercare are unaffordable services and fear of being abandoned by the children. The major concerns toward community-based eldercare includes affordability and lack of necessary services. In summary, elderly having concerns toward home-based care and having no concerns about institutional care are willing to accept institutional eldercare. Elderly who are living alone is tend to accept community-based care. Unaffordable services and loss of contact with family members are the major concerns of institutional eldercare. Aside from the cost, the lack of necessary care services is also a serious concern of community-based eldercare.