BACKGROUND

Urban populations are ageing rapidly, and communities face increasing pressure to provide well-being services that meet the diverse needs of older adults. However, in rapidly ageing societies such as China, one-size-fits-all service models often result in misalignment with the actual needs of the elderly, leaving needs unmet. This study applies the Kano model to identify the hierarchy of community-based service needs among urban elderly residents and determine a prioritized sequence of service provision to guide improvements in service supply.

METHOD

This study employed a cross-sectional survey design to investigate the prioritized service needs of the urban elderly. A structured questionnaire, developed based on existing literature and expert consultation, was administered to 887 elderly residents aged 60 and above in the Zhenhai District of Ningbo City, China. The survey captured demographic information and assessed demand across 33 community-based elderly care service items.The Kano model was utilized as the primary analytical framework to classify service attributes into five categories: attractive, one-dimensional, must-be, indifferent, and reverse qualities. Participants' perceptions were analyzed using the evaluation matrix method specific to Kano analysis, allowing for the identification of services with the greatest potential to influence satisfaction. Data were statistically analyzed using SPSS 26.0, and descriptive as well as cross-tabulation techniques were applied to characterize service preferences and their associations with demographic variables.

CONCLUSIONS

Among the 33 service items, 6 were identified as attractive demands (A) and 27 as indifferent demands (I). The elderly's expectation level for welfare service items was significantly higher than their dependence level. Moreover, the satisfaction index (SI) for all A-type welfare service items was ≥ 0.50, indicating that these services had a notably stronger effect on satisfaction enhancement. Comparative analysis revealed that demand for welfare services varied across different age groups, income levels, and marital statuses.