Preferences in long-term care models and related factors among older adults: a cross-sectional study from Shandong Province, China

The growth of the aging population has been accompanied throughout a rapid increase in the number of disabled people and the demand for long-term care (LTC) services. Shandong Province has the largest number of older adults in China. It is necessary to explore their preferences in LTC models and the related factors. In a cross-sectional study conducted in August 2017, 6997 older adults aged 60 years and older were interviewed. Descriptive analysis, independent sample t tests, chi(2) tests, and multinomial logistic regression were used to show preferences and the related factors in LTC models (family care, home- and community-based care (HCBS), and institutional care) based on the Andersen Behavior Model. Family care (89.1%) was the first preference for older adults and 8.2% chose institutional care, but only 2.7% chose HCBS. The logistic regression results indicated that older people aged 60-64 years and those with a higher education level tended to choose HCBS or institutional care (P < 0.05); in the eastern region of Shandong Province, they tended to choose HCBS and institutional care over family care (P < 0.05). Older people with self-care limitations were more likely to choose HCBS (P < 0.05). Older adults with a stronger sense of loneliness were more likely to choose HCBS and institutional care (P < 0.05). The results can enable us to make tentative recommendations for older people, relevant decision-makers, and administrative bodies. Additionally, a more rigorous longitudinal design is necessary to investigate causality in regard to related factors and preference in LTC models.