Measurement of the coupling coordination level and influencing factors of community healthcare services and older adults care services in China

BACKGROUND: With the continuous increase in morbidity among older adults and the rapid progression of population aging, the demand for healthcare services and older adults care services has grown rapidly. However, the traditional model characterized by the separation of healthcare and older adults care has become increasingly inadequate in meeting the diverse and expanding needs of the aging population. Therefore, promoting the coordinated development of healthcare services and older adults care services has emerged as an urgent and critical issue. METHOD: Based on panel data from 31 provinces (including municipalities and autonomous regions) in China from 2014 to 2023, this study employs the entropy method, the coupling coordination degree model, and the geographic detector model to analyze the level of coordinated development and its key influencing factors between community-level healthcare services and older adults care services at the provincial scale. Specifically, the entropy method is used to determine indicator weights, the coupling coordination degree model is applied to evaluate the coordination level, and the geographic detector model is utilized to identify the main influencing factors. RESULTS: (1)The coupling coordination level between community healthcare services and older adults care services in China shows an overall upward trend, although the growth rate is uneven, exhibiting a dynamic evolution characterized by "rapid development-gradual slowdown-bottoming out and rebound-fluctuating advancement."(2)Significant spatial disparities are observed in the coupling coordination level, gradually forming a diversified spatial pattern in which coastal regions take the lead, inland regions rise rapidly, and remote regions demonstrate substantial development potential.(3)The coupling coordination development of community healthcare services and older adults care services in China is jointly influenced by infrastructure, workforce, and service capacity. Among these factors, the number of healthcare institutions, the number of technical staff, the number of outpatient visits, the number of older adults care institutions, the number of certified social workers, and the number of community-based daytime care recipients play a dominant promoting role. CONCLUSION: Based on the findings, this study recommends implementing dynamic regulatory strategies aligned with different development stages, formulating region-specific policies that account for spatial heterogeneity, and adopting targeted interventions focusing on key influencing factors, in order to systematically promote the high-quality coordinated development of healthcare services and older adults care services in China.