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

OBJECTIVE: To 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. METHODS: A 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. RESULTS: Only 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. CONCLUSIONS: A 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.