Utilisation willingness for institutional care by the disabled elderly and its influencing factors based on Andersen’s model: a cross-sectional survey of Henan, China

OBJECTIVE: To explore the factors that influence institutional care for the disabled elderly in China and the key factors that influence individuals based on the Andersen model. DESIGN: Cross-sectional survey. SETTING: The research was conducted in 18 cities in Henan Province, China. MAIN OUTCOME MEASURES: A multistage, stratified sampling design was employed. The χ(2) test was used to compare the differences in basic information of the disabled elderly. A binary Logit model was used to examine the factors influencing the willingness to institutionalise elderly people with disabilities. The determinants of willingness to care in an institution were also explored in a stratified study by gender, age and region to identify the key differences affecting institutionalisation. The Andersen model was used as the theoretical framework to infer the impact strength of each model. RESULTS: Of the 2810 disabled elderly people in Henan, China, 7.4% of the elderly had a willingness for institutional care. In the binary logistic regression analysis, whether living alone (OR (95% CI)=0.596 (0.388 to 0.916)), medical payment method (basic medical insurance for urban employees: OR (95% CI)=2.185 (1.091 to 4.377)), having mental illness (OR (95% CI)=2.078 (1.044 to 4.137)) had a statistically significant difference (p<0.05) on the impact on the willingness of the disabled elderly to receive institutional care. Validation of the fitted coefficients of the model revealed that the needs factor had the most significant effect on the enabling variable, while the predisposing factor had more minerally effect. CONCLUSIONS: Several factors influence the willingness of the disabled elderly to institutionalise. Therefore, it is recommended that relevant authorities take targeted measures to focus on the disabled elderly to identify more precise elderly care services to deal with the ageing crisis.