Willingness to purchase institutionalised elderly services and influencing factors among Chinese older adults: a nationwide cross-sectional study

Objectives In view of the serious ageing of China's population and the low desire of elderly people to purchase institutionalised elderly care services, we explored the willingness of Chinese elderly people to purchase institutionalised elderly care services and its influencing factors.Design This was a cross-sectional study. Three multivariate logistic regression analysis models of the willingness of elderly people to purchase institutionalised elderly care services were established (model 1: 'reluctance - willingness'; model 2: 'reluctance - hesitation'; and model 3: 'hesitation - willingness') to explore the factors that influence elderly people's willingness to purchase institutionalised elderly care services.Setting This study was based on the 2022 Psychology and Behaviour Investigation of Chinese Residents database.Participants Research data from 4123 older adults who met the requirements of this study were screened from the database.Results Of the 4123 respondents, roughly equal numbers had negative and positive attitudes towards purchasing institutionalised senior care services (1125, 27.3% vs 1079, 26.2%, respectively), and 1919 (46.5%) had hesitant attitudes. The analysis of model 1 showed that medical insurance participation, the number of children and siblings, chronic diseases and per capita monthly household income had an influential effect on the willingness of elderly people to purchase institutional care. In model 2, we found that factors such as per capita monthly household income and anxiety led to hesitancy among older adults to purchase institutionalised senior care services. In model 3, we further found that social support and health literacy led to a shift from hesitation to willingness to purchase institutionalised elderly care services.Conclusion The number of children, number of siblings, per capita monthly income of the family, medical insurance participation, health status, health literacy and social support were found to be the main factors influencing the purchase of institutionalised care by elderly individuals.