Individual Factors Influencing the Use of Home- and Community-Based Care Services by Disabled Elderly Individuals in Urban Areas: Evidence from Beijing, China

China's rapidly aging population necessitates a sustainable social care system. Although the majority of Chinese disabled older adults live in their communities, the utilization rate of home- and community-based care (HCBC) services has been low. Moreover, family members still take the main responsibility for the care of disabled older persons and generally suffer from the stress of caregiving. To increase the use of HCBC services by disabled elderly families, this study examined which individual characteristics of both elderly individuals and their primary family caregivers were related to HCBC service use among disabled urban elderly individuals in a regional sample from the 2018 to 2019 Beijing Precise Assistance Need Survey (n = 34,153). Logistic regression was used as the baseline model, and a simultaneous equation model was established to address the jointly dependent variables. The results show that the degree of disability of disabled older adults has no significant effect on their service use, whereas their worse health status played a significant role in predicting respite care service use. Working status, a longer period of caregiving, and poor health of caregivers all significantly predict a greater likelihood of service use by elderly individuals. Caregivers with burdened feelings predicted a decrease in the likelihood of elderly individuals using services. Our findings show that primary family caregivers have an important influence on disabled elderly people's use of HCBC services, but service use is more likely to compensate for the lack of care and expertise provided by family caregivers than to reduce caregivers' caregiving burden.