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Health services research
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Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China
  1. Yangyang Qian1,
  2. Wen Qin2,
  3. Chengchao Zhou1,3,
  4. Dandan Ge1,
  5. Li Zhang1,
  6. Long Sun1
  1. 1 School of Public Health, Shandong University, Jinan, China
  2. 2 Shandong University Hospital, Shandong University, Jinan, Shandong, China
  3. 3 Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
  1. Correspondence to Professor Chengchao Zhou; zhouchengchao{at}sdu.edu.cn

Abstract

Introduction Institutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.

Methods A total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.

Results Our study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.

Conclusions The government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

  • institutional care
  • willingness
  • elderly
  • empty-nest
  • determinants

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-022324

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    Footnotes

    • YQ and WQ are co-first authors.

    • YQ and WQ contributed equally.

    • Contributors CZ, YQ and WQ conceived the idea, CZ implemented the field study. CZ, YQ, DG and LZ participated in the statistical analysis and interpretation of the results. YQ drafted the manuscript. CZ, WQ and LS gave many valuable comments on the draft and polished it. All authors read and approved the final manuscript.

    • Funding This study was funded by the National Natural Science Foundation of China (7100306,71473152 and 71774104), Cheeloo Young Scholar Grant and Shandong University (IFYT1810, 2012DX006).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Ethical approval was obtained from The Ethical Committee of Shandong University School of Public Health.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.