Factors associated with willingness to enter long-term care facilities among older adults in Chengdu, China

ObjectiveTo describe Chinese older adults’ willingness to enter long-term care facilities and to examine individual factors associated with the willingness of using this growing model of long-term care in China.MethodsA cross-sectional study involving a random sample of 670 adults aged 60+ in the Hezuo community in Chengdu, China in 2016. Respondents were interviewed by trained staff on socio-demographics, health status, quality of life, social support, and willingness to enter long-term care facilities.ResultsOnly 11.9% of the respondents were willing to enter long-term care facilities for meeting their medical and social service needs. Multivariable logistic regression analysis showed that willingness to enter long-term care facilities was associated with higher household income (OR = 4.55, 95% CI:1.72–12.00), insurance of Urban Resident Basic Medical Insurance (OR = 4.80, 95% CI:1.17–19.67) and unemployment (OR = 0.48, 95% CI:0.24–0.99). Among those who were willing to enter long-term care facilities, an overwhelming majority (81.2%) would prefer going to a facility within 30-minute walking distance from their current residence, 82.5% indicated the need of nursing care, and 90.0% expected a partnership between the long-term care facility and a large hospital.ConclusionsA minority of older Chinese were willing to receive long-term care delivered at a facility within walking distance from their current residence. Recent policy aimed at increasing the supply of long-term care facilities may not be consistent with consumer preference for home and community-based care. Balancing investment between home and community-based care, and establishing long-term care insurance remain the top priorities for long-term care research and policy development in China.研究目的：描述中国老年人入住长期照护机构（long-term care facilities）的意愿，并探讨与中国这一日益发展的长期照护模式使用意愿相关的个体影响因素。 研究方法：本研究为横断面研究，于2016年在中国成都合作社区抽取670名60岁及以上成年人作为随机样本。由经过培训的研究人员对受访者进行访谈，内容涵盖社会人口学特征、健康状况、生活质量、社会支持以及入住长期照护机构的意愿。 研究结果：仅11.9%的受访者愿意为满足自身医疗与社会服务需求而入住长期照护机构。多因素logistic回归分析显示，入住长期照护机构的意愿与更高的家庭年收入（优势比（Odds Ratio，OR）=4.55，95%置信区间（Confidence Interval，CI）：1.72~12.00）、城镇居民基本医疗保险（Urban Resident Basic Medical Insurance）参保状态（OR=4.80，95%CI：1.17~19.67）以及失业状态（OR=0.48，95%CI：0.24~0.99）显著相关。在愿意入住长期照护机构的受访者中，绝大多数（81.2%）更倾向于选择距离当前居所步行30分钟以内的机构，82.5%的受访者表示需要护理服务，90.0%的受访者期望长期照护机构与大型医院建立合作关系。 研究结论：仅少数中国老年人愿意选择距离居所步行可达范围内的长期照护机构接受服务。当前旨在增加长期照护机构供给的政策，或与老年人对居家社区照护的偏好不相契合。在中国，均衡居家与社区照护的资源投入、建立长期照护保险制度，仍是长期照护领域研究与政策制定的首要任务。