School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China.
Institute of Income Distribution and Public Finance, Zhongnan University of Economics and Law, Room 130 in the Wenqin Building, No. 182 Nanhu Road, Donghu New Technology Development Zone, Wuhan, 430073, China.
Int J Equity Health. 2021 Sep 8;20(1):203. doi: 10.1186/s12939-021-01544-w.
To address the challenge of the aging population, community-based care services (CBCS) have been developed rapidly in China as a new way of satisfying the needs of elderly people. Few studies have described the evolution trend of availability of CBCS in rural and urban areas and evaluated their effectiveness. This study aims to show the availability of China's CBCS and further analyze the effect of the CBCS on the cognitive function of elderly people.
Longitudinal analysis was performed using data from the 2008 to 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 23937 observations from 8421 elderly people were included in the study. The Chinese version of the Mini-Mental State Examination (MMSE) was used to assess cognitive function. We aggregated similar CBCS to generate three binary variable categories (daily life support, emotional comfort and entertainment services, medical support and health services) indicating the availability of CBCS (1 = yes, 0 = no). Multilevel growth models were employed to estimate the association between CBCS and cognitive function while adjusting for many demographic and socioeconomic characteristics.
The availability of CBCS increased a lot from 2008 to 2018 in China. Although the availability of CBCS in urban areas was higher than that in rural areas in 2008, by 2018 the gap narrowed significantly. Emotional comfort and entertainment services (B = 0.331, 95% CI = 0.090 to 0.572) and medical support and health services (B = 1.041, 95% CI = 0.854 to 1.228) were significantly and positively associated with cognitive function after adjusting for the covariates.
There was a significant increase in the availability of CBCS from 2008 to 2018 in China. This study sheds light on the positive correlation between CBCS and cognitive function among Chinese elderly individuals. The results suggest that policymakers should pay more attention to the development of CBCS and the equity of the supply of CBCS in urban and rural areas.
为应对人口老龄化挑战，中国迅速发展社区养老服务（CBCS），作为满足老年人需求的新方式。很少有研究描述农村和城市地区 CBCS 供应的演变趋势，并评估其效果。本研究旨在展示中国 CBCS 的供应情况，并进一步分析 CBCS 对老年人认知功能的影响。
使用中国 2008 年至 2018 年中国长寿纵向研究（CLHLS）的数据进行纵向分析。共纳入 8421 名老年人的 23937 个观测值。使用中文版简易精神状态检查（MMSE）评估认知功能。我们将类似的 CBCS 汇总为三个二分类变量类别（日常生活支持、情感舒适和娱乐服务、医疗支持和健康服务），表示 CBCS 的可用性（1=是，0=否）。多水平增长模型用于估计 CBCS 与认知功能之间的关联，同时调整了许多人口统计学和社会经济特征。
2008 年至 2018 年，中国 CBCS 的可用性大大增加。尽管 2008 年城市地区的 CBCS 可用性高于农村地区，但到 2018 年，差距明显缩小。情感舒适和娱乐服务（B=0.331，95%CI=0.090 至 0.572）和医疗支持和健康服务（B=1.041，95%CI=0.854 至 1.228）在调整了协变量后与认知功能呈显著正相关。
2008 年至 2018 年，中国 CBCS 的可用性显著增加。本研究揭示了 CBCS 与中国老年人群认知功能之间的正相关关系。结果表明，政策制定者应更加关注 CBCS 的发展和城乡 CBCS 供应的公平性。
