# The relationship between structural characteristics of long-term care institutions and their initial operating budgets

**Authors:** Xiaojing Wang, Peter C. Coyte

PMC · DOI: 10.3389/fpubh.2025.1669451 · Frontiers in Public Health · 2025-10-02

## TL;DR

This study examines how the structural features of long-term care institutions in Shanghai affect their initial operating budgets.

## Contribution

The study reveals a U-shaped relationship between facility size and budgets, and identifies factors like competition and ownership type as key influences.

## Key findings

- A U-shaped relationship exists between gross floor area and initial operating budgets.
- Publicly constructed institutions have lower budgets than privately constructed ones.
- Staffing arrangements and property ownership significantly affect initial budgets.

## Abstract

In the context of a rapidly aging population, this study focuses on an important issue concerning long-term care institutions, attempting to explore the relationship between structural characteristics and initial operating budgets.

Data analysis was performed based on 581 long-term care institutions collected from the Shanghai Municipal Civil Affairs Bureau. Statistical analyses were conducted using IBM SPSS Statistics 24.0 with the PROCESS macro (version 3.5) for moderation analyses and Stata 16.0 for endogeneity tests.

The analyses revealed a significant U-shaped relationship between the gross floor areas of long-term care institutions and their initial operating budgets. Industry competition negatively moderated the effect of gross floor area on initial operating budget and also significantly exerted a direct negative effect on budgets. In addition, staffing arrangement showed a positive effect on initial operating budgets. Ownership type mattered: publicly constructed institutions had significantly lower initial operating budget compared to privately constructed institutions, whereas publicly operated institutions were associated with significantly higher initial operating budgets than privately operated ones. Institutions with leased property reported lower initial operating budgets than those with self-owned property.

This study demonstrates that the initial operating budgets of long-term care institutions are significantly associated with their structural characteristics.

## Full-text entities

- **Diseases:** COVID-19 (MESH:D000086382), illness (MESH:D002908), dementia (MESH:D003704)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

66 references — full list in the complete paper: https://tomesphere.com/paper/PMC12528046/full.md

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Source: https://tomesphere.com/paper/PMC12528046