Aim: To explore changes in home- and community-based service utilisation and its associated factors among Chinese older adults between 2016 and 2018.
Design: A national cohort study.
Methods: This study included 6924 older adults from the China Longitudinal Aging Social Survey 2016 and 2018 waves, examining the changes in service utilisation among four groups: continuous users, former users, new users and nonusers. Multinomial logistic models were employed to identify the determinants of service utilisation changes, and dominance analysis was performed to compare the relative contribution of the main variables associated with utilisation changes.
Results: Overall, there was an approximate 6% increase in the utilisation of any services among the study population from 2016 to 2018. The changes in service utilisation among four groups were 6.9% as continuing users, 4.2% as former users, 10.1% as new users and 78.8% as nonusers from 2016 to 2018, respectively. Factors associated with utilisation changes, ranked from the most to the least relative contribution, included availability of services, living region, type of pension, activities and instrumental activities of daily living, personal income, age and living alone.
Conclusions: Despite an increase in service utilisation, low services utilisation remains a concern. Strengthening policy support and boosting financial investments in home- and community-based services to enhance availability across all regions would be an effective measure to improve service utilisation.
Implications for the profession and/or patient care: The study highlights the need for long-term care professionals and policymakers to increase availability to home- and community-based services, especially in underserved areas.
Impact: Identifying key factors associated with changes in service utilisation, such as service availability and living region, can guide targeted strategies to improve access and equity.
Patient or public contribution: No patient or public contribution.
Reporting method: STROBE statement (Table S5).
Keywords: associated factors; changes; home nursing; home‐ and community‐based services; older adults; utilisation.
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