Can formal home and community-based care substitute informal care? Evidence from Chinese Longitudinal Healthy Longevity Survey

TL;DR

This study examines how formal home and community-based care services in China affect informal caregiving, finding that certain services reduce caregiving hours and costs.

Contribution

The study identifies specific formal care services that effectively reduce informal caregiving burdens, particularly for those with high care needs.

Findings

Daily living assistance services reduce informal caregiving hours, especially for those with extensive care needs.

Community-based health care services lower direct caregiving expenses, particularly for those with higher costs.

Effects are more pronounced in urban areas, while mental health and legal services show no significant impact.

Abstract

Formal home and community-based care are often considered as the preferable option to institutional care, offering older individuals the convenience of receiving care in their homes. Although research has found that these services may alleviate the burden on informal caregivers, there is a lack of research on which specific types of formal home and community-based care influence informal care provision.

Employing fixed-effects and quantile regression models, this study seeks to explore the effects that various formal home and community-based care services have on reducing the burden of informal care. This study draws data from the Chinese Longitudinal Healthy Longevity Survey 2005, 2008, 2011, 2014, and 2018.

Our findings indicate that two types of formal care substantially influence the provision of informal care. The availability of daily living assistance services correlates with reduced informal caregiving hours, especially for those with extensive care needs. The availability of community-based health care services is linked to a reduction in the direct expenses incurred from informal caregiving, especially for those incurring greater direct caregiving costs. These effects are more prominent among urban residents. Other services, such as mental health support and legal advice services, do not demonstrate significant effects on reducing informal care hours and costs.

Daily living assistance and community-based health care services play a crucial role in benefiting informal caregivers. It is important to prioritize the expansion of these services, especially among those with greater care needs.

The online version contains supplementary material available at 10.1186/s12877-024-05312-7.