珠三角地区城乡老年人养老服务需求倾向及养老意愿的差异性分析

BSTRACT: Objective To understand the differences in the demand for elderly care services between urban and rural residents in the Pearl River Delta (PRD), and to provide reference for promoting the balanced development of elderly care services in urban and rural areas. Methods Using multi-stage stratified random sampling method, we selected 7 community health service centers in 2 prefecture-level city in the PRD, and conducted a questionnaire survey on 1919 permanent residents aged 60 years and above who visited the centers. Results A total of 641 urban elderly people (33.4%) and 1278 rural elderly people (66.6%) were surveyed in the PRD. The proportion of elderly people with only children in urban areas is significantly higher than that in rural areas (22.2% vs 8.7%; p<0.001). The proportion of urban elderly people who purchase socialized elderly care services when needed is significantly higher than that of rural elderly people (30.0% vs 15.3%; p<0.001). The proportion of rural elderly people agreeing to the concept of raising children and preventing aging is higher than that of urban elderly people (76.1% vs 58.2%; p<0.001); 37.3% and 19.9% of urban and rural elderly people respectively stated that sudden public health incidents have an impact on their elderly care planning. The proportion of elderly people in rural areas who prefer family based elderly care is higher than that in urban areas (71.8% vs 57.1%; p<0.001). The proportion of urban elderly people clearly expressing their willingness to choose institutions for elderly care is significantly higher than that of rural elderly people (62.6% vs 44.0%; p<0.001). Taking family elderly care as a reference, among urban elderly people, the willingness to choose institutional elderly care is lower for those with "surplus" monthly household income and expenditure [OR (95% CI): 0.038 (0.006-0.246)] and "basically equal" [OR (95% CI): 0.072 (0.012-0.431)], and those who agree to the concept of raising children and preventing aging [OR (95% CI): 0.318 (0.110-0.923)]. Urban males [OR (95% CI): 1.544 (1.058-22.54)] and the elderly who purchase socialized elderly care services [OR (95% CI): 2.208 (1.213-4.020)] and those who believe that sudden public health events have an impact on their elderly care planning [OR (95% CI): 1.806 (1.183-2.757)] tend to prefer community based home-based elderly care. The rural elderly with local registered residence registration are more inclined to institutional pension [OR (95% CI): 4.237 (1.031-17.405)] and community home-based pension [OR (95% CI): 1.463 (1.057-2.024)], while those who have more than one child [OR (95% CI): 0.156 (0.050-0.482)], and the rural elderly who agree with the concept of raising children to prevent old age [OR (95% CI): 0.318 (0.110-0.923)] are less willing to choose community home-based pension, Rural elderly people who believe that sudden public health events have an impact on elderly care planning [OR (95% CI): 3.260 (1.002-10.600)] tend to prefer institutional elderly care. Conclusions There is a significant difference in the attitudes of elderly people in urban and rural areas towards the concept of raising children and preventing aging. Urban elderly people are more likely to accept socialized elderly care services compared to rural elderly people, and the impact of sudden public health events on elderly care planning is similar between urban and rural areas. It is suggested that in addition to strengthening the function of family elderly care, urban and rural elderly care resources should be reasonably allocated based on the differences between urban and rural areas.