A Study on the Influencing Factors of Elderly Care Service Levels in China

2022年全国29个省份为样本，基于社区、居家和机构三类养老服务构建测度指标体系，综合考察经济发展和老龄化程度对养老服务水平的影响。通过构建空间计量模型，系统分析养老服务的空间分布特征及其影响机制。研究结果表明：省域经济发展水平正向影响本地三类养老服务水平，并对相邻地区社区养老产生复杂作用，对居家养老具有抑制性溢出效应；老龄化程度显著提升本地居家养老服务水平，但降低机构养老发展，对邻近地区社区养老水平亦有抑制作用。基于上述结论，提出部分建议：加强社区卫生服务中心建设，推动区域协同发展与资源共享；发展居家养老应采取协调发展的策略；加大对机构养老的政策支持，优化社区、居家与机构养老的协同布局。As of the end of 2023, the population aged 65 and above in China reached 15.4%, marking the entry into a deeply aging society. This study employs panel data from 29 Chinese provinces spanning 2012 to 2022 to develop a comprehensive indicator system measuring elderly care service levels across three dimensions: Community-based, home-based, and institutional care. The effects of economic development and population aging on these service levels are examined. Utilizing spatial econometric models, the study systematically explores the spatial distribution patterns of elderly care services and their underlying influencing mechanisms. Findings indicate that provincial economic development positively affects all three types of elderly care services locally, while exerting complex spillover effects on neighboring provinces’ community-based services and inhibitory effects on neighboring home-based services. Population aging significantly enhances local home-based care levels but reduces institutional care development, and suppresses community-based care in adjacent regions. Based on these results, policy recommendations include strengthening community health service centers, promoting regional cooperation and resource sharing, adopting coordinated development strategies for home-based care, increasing policy support for institutional care, and optimizing the integrated development of community, home, and institutional elderly care services.