Evolutionary game analysis of rural public–private partnership older adult care project in the context of population aging in China

INTRODUCTION: Public–private partnership (PPP) older adult care project is an effective means to solve the dilemma of the aging population in China's rural areas, but there are some problems in the operation process, such as a low participation rate and poor service quality, resulting in the needs of rural older adult groups not being met. METHODS: To alleviate the pressure of the aging population in rural areas, this study establishes an evolutionary game model for the PPP older adult care project, then defines the interests of local government, the private sector, and rural older adult residents, based on which it discusses the strategic choices of the three parties in the evolutionary process, and finally analyzes the influencing factors of the strategic choices of the game parties through simulation. RESULTS: The results suggest that whether the private sector chooses to actively participate in the project will be influenced by the willingness of local government and rural older adult residents to participate in the project. Local government could play the role of supervisor through reward and punishment mechanisms. Whether older rural residents choose to participate in the project depends on the number of benefits they would receive. DISCUSSION: Based on these findings, local governments should clarify the responsibilities of relevant stakeholders, adopt a regulatory strategy combining subsidies and penalties, improve the participation efficiency of rural older adult residents, promote the effective operation of PPP older adult care projects, and improve the quality of rural older adult care services in the new era.