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

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 sociodemographic 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.