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Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model

Author

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  • Yong Wei

    (Department of Statistics, School of Economics, Xiamen University, 422 Siming South Road, Xiamen 361005, China
    School of Accounting, Jiangsu Vocational College of Finance and Economics, Huaian 223003, China)

  • Liangwen Zhang

    (Department of Statistics, School of Economics, Xiamen University, 422 Siming South Road, Xiamen 361005, China
    State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China)

Abstract

Background: The purpose of this study is to evaluate the status quo and factors that influence the preferences of the elderly for the combination of medical care and pension (CMCP) in long-term care (LTC) facilities and to provide an evidence-based basis for building a multi-tiered, continuous LTC system with CMCP. Methods: Using a multi-stage sampling method, face-to-face questionnaire surveys were conducted on 3260 elderly people aged 60 years or over in 44 communities in 16 sub-districts in six districts in Xiamen. Based on the Andersen model, the chi-square test was used to analyze differences in population distribution, and binary logistic regression analysis was used to analyze the factors affecting the elderly’s preference for CMCP in LTC institutions in terms of the factors of predisposition, enablement, and personal needs. Results: Most elderly people choose traditional home care (82.01%), and only 12.89% choose LTC facilities with CMCP. This choice is influenced by a number of predisposing factors. The elderly who are at the upper end of the age range, have a higher education level, and live in rural areas are more likely to choose CMCP (odds ratio (OR) value greater than 1, p < 0.05). With regard to enabling factors, the elderly who were married, mainly taken care of by spouses, and had better economic status also tended to choose CMCP (OR > 1, p < 0.01). In terms of personal needs, the elderly with worse self-care status tended to choose CMCP (OR > 1, p < 0.01). Enabling factors have the largest contribution to the model, and they have the greatest impact on elder preference for CMCP services. In addition, the elderly with higher age and education level, non-remarried, with better economic status, and with poorer health status have a demand for a wider variety of CMCP services. Compared to those in urban areas, the elderly in rural areas have greater needs, mainly related to personal care, medical care, and psychological counseling. Conclusion: The preference of the elderly for CMCP are lower compared to their preference for home care in Xiamen, China. Preference for CMCP is affected by a range of factors such as age, education level, residence, income, and self-care ability, among which the enabling factors have the greatest impact.

Suggested Citation

  • Yong Wei & Liangwen Zhang, 2020. "Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model," IJERPH, MDPI, vol. 17(15), pages 1-14, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5436-:d:391029
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    References listed on IDEAS

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    1. Liangwen Zhang & Yanbing Zeng & Ya Fang, 2017. "The effect of health status and living arrangements on long term care models among older Chinese: A cross-sectional study," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-15, September.
    2. Worawan Chandoevwit & Nada Wasi, 2019. "Estimating Demand for Long-term Care Insurance in Thailand: Evidence from a Discrete Choice Experiment," PIER Discussion Papers 106, Puey Ungphakorn Institute for Economic Research.
    3. Liangwen Zhang & Sijia Fu & Ya Fang, 2020. "Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China," Sustainability, MDPI, vol. 12(7), pages 1-13, March.
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    1. Tongbo Deng & Yafan Fan & Mengdi Wu & Min Li, 2022. "Older People’s Long-Term Care Preferences in China: The Impact of Living with Grandchildren on Older People’s Willingness and Family Decisions," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    2. Antonio Sarría-Santamera & Alua Yeskendir & Tilektes Maulenkul & Binur Orazumbekova & Abduzhappar Gaipov & Iñaki Imaz-Iglesia & Lorena Pinilla-Navas & Teresa Moreno-Casbas & Teresa Corral, 2021. "Population Health and Health Services: Old Challenges and New Realities in the COVID-19 Era," IJERPH, MDPI, vol. 18(4), pages 1-5, February.
    3. Lea de Jong & Jan Zeidler & Kathrin Damm, 2022. "A systematic review to identify the use of stated preference research in the field of older adult care," European Journal of Ageing, Springer, vol. 19(4), pages 1005-1056, December.

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