@article{01JGP62DP75VZR5JWKC9M38DDH,
  abstract     = {{Aim: To explore changes in home- and community-based service utilization and its associated factors among Chinese older adults between 2016 and 2018. 
Design: A national cohort study.
Methods: This study included 6,924 older adults from the China Longitudinal Aging Social Survey 2016 and 2018 waves, examining the changes in service utilization among four groups: continuous users, former users, new users, and non-users. Multinomial logistic models were employed to identify the determinants of service utilization changes, and dominance analysis was performed to compare the relative contribution of the main variables associated with utilization changes.
Results: Overall, there was an approximate 6% increase in the utilization of any services among the study population from 2016 to 2018. The changes in service utilization among four groups were: 6.9% as continuing users, 4.2% as former users, 10.1% as new users, and 78.8% as non-users from 2016 to 2018, respectively. Factors associated with utilization changes, ranked from the most to the least relative contribution, included availability of services, living region, type of pension, activities and instrumental activities of daily living, personal income, age, and living alone.
Conclusions: Despite an increase in service utilization, low services utilization remains a concern. Strengthening policy support and boosting financial investments in home- and community-based services to enhance availability across all regions would be an effective measure to improve service utilization.
Implications for the profession and/or patient care: The study highlights the need for long-term care professionals and policymakers to increase availability to home- and community-based services, especially in underserved areas. 
Impact: Identifying key factors associated with changes in service utilization, such as service availability and living region, can guide targeted strategies to improve access and equity. 
Patient or Public Contribution: No patient or public contribution.
Reporting Method:  STROBE statement.}},
  author       = {{Yu, Yushan and Zheng, Xiaoying and Petrovic, Mirko and Zhang, Wei Hong}},
  issn         = {{0309-2402}},
  journal      = {{JOURNAL OF ADVANCED NURSING}},
  keywords     = {{Home- and community-based services,Home nursing,Utilization,Trends,Associated factors,Older adults,CARE,POPULATION,PREVALENCE,HEALTH,POLICY,SCALE}},
  language     = {{eng}},
  pages        = {{13}},
  title        = {{Analysis of changes in home- and community-based service utilization among Chinese older adults : a national cohort study}},
  url          = {{http://doi.org/10.1111/jan.16704}},
  year         = {{2025}},
}

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