Digital Empowerment, Expansion of the Elderly Care Provision, and Equitable Resource Allocation: Evidence from China’s Smart Health and Elderly Care Pilot Program

Digital technologies are increasingly integrated into elderly care systems and have important implications for sustainable social development. This study investigates whether China’s Smart Health and Elderly Care (SHEC) Pilot Program enhances elderly care service provision and improves the spatial equity of resource distribution. Using prefecture-level data on elderly care institutions from 2010 to 2021, this paper employs a staggered difference-in-differences (DID) approach to identify the impact of SHEC on elderly care service provision. SHEC is treated as a digitally oriented policy initiative rather than a direct measure of digital technology adoption intensity. The results show the following: First, the pilot program significantly expands the service capacity of the elderly care system, as reflected in increases in both the number of elderly care institutions and bed capacity. Second, the policy has stronger effects on service capacity expansion in less-developed and high-aging regions, whereas the estimated effects are limited in more-developed and low-aging regions. Third, the analysis also provides exploratory evidence on potential supply-side and demand-side mechanisms. Finally, the equity analysis based on the Theil index suggests that participation in SHEC improves allocative equity, thereby supporting sustainable social development. This paper contributes to the literature by highlighting how digital empowerment-oriented policy interventions in the elderly care sector promote the sustainable expansion and equitable allocation of public service resources.