Supply-demand structural analysis of sports services in Chinese residential care facilities: a cross-sectional study in Zhengzhou

TL;DR

This study examines the mismatch between demand and supply of sports services in Chinese residential care facilities, finding significant gaps and identifying factors like satisfaction and income as key predictors.

Contribution

The study introduces a novel application of the SERVQUAL gap model to assess supply-demand matching in sports services for elderly care in China.

Findings

Facilities and fitness guidance showed the strongest demand but poorest supply, with shortage rates over 25%.

Satisfaction, education level, and monthly income were significant predictors of supply-demand matching.

Institution type had no significant direct effect on supply-demand gaps after controlling for demographics.

Abstract

Sports services constitute an important non-medical intervention for promoting healthy aging. China has the world's largest older population with growing demand for institutional care; however, systematic research on supply-demand matching of sports services in residential care facilities remains scarce.

This cross-sectional study surveyed 278 older adults across 15 residential care facilities in Zhengzhou, China, between March and June 2025. Based on the SERVQUAL gap model, supply-demand status was assessed across five dimensions: facilities, fitness guidance, activity organization, information consultation, and physical monitoring. The dependent variable was constructed using a project counting method: the supply side was measured by service accessibility (SA1–SA5, binary items assessing “whether the institution provides the service”), and the demand side by the number of dimensions with urgent needs (demand mean > 4.0); a difference ≤ 0 was coded as supply deficit. Binary logistic regression was employed with overall satisfaction (Z-standardized) as the core independent variable to examine predictors of supply-demand matching. Cronbach's α coefficients ranged from 0.767 to 0.845 across dimensions.

A pronounced structural imbalance in supply and demand was identified. Facilities (gap = 1.03, shortage rate 25.6%) and fitness guidance (gap = 1.02, shortage rate 25.2%) exhibited the strongest demand yet poorest supply, whereas activity organization was relatively well-supplied but ranked lower in demand priority. Significant demographic differences existed across institution types: residents of public institutions had significantly lower self-care ability than those in private institutions (M = 1.65 vs. 1.93, p = 0.027) and lower monthly income (M = 2.17 vs. 2.62, p = 0.005); however, overall satisfaction (p = 0.695) and supply-demand gap rates (p = 0.705) did not differ significantly across institution types. Logistic regression (Nagelkerke R2 = 0.223, LLR χ2 = 49.06, p < 0.001) revealed that overall satisfaction (OR = 0.484, p < 0.001), education level (OR = 0.612, p = 0.002), and monthly income (OR = 0.604, p < 0.001) significantly predicted supply-demand matching. After controlling for demographic variables, institution type was non-significant (private OR = 0.801, p = 0.500; public-private partnership OR = 0.922, p = 0.813), suggesting that inter-institutional differences were primarily attributable to a compositional effect. Among 278 respondents, 97 (34.9%) were classified in the supply-deficit group and 181 (65.1%) in the supply-demand balance group.

Sports services in residential care facilities exhibited a structural contradiction characterized by the coexistence of “high demand-low supply” and “low demand-high supply.” Satisfaction, education level, and monthly income were identified as three key predictors of supply-demand imbalance: older adults with higher satisfaction (i.e., better perceived service quality) had lower odds of supply deficit, while those with higher education and income were associated with less supply-demand mismatch, potentially owing to superior information access and resource utilization capabilities. The non-significant effect of institution type, combined with demographic comparisons, suggested a compositional effect—public institutions bore greater responsibility for functionally impaired and economically vulnerable older adults, yet this structural difference in resident composition was not associated with significant differences in sports service supply-demand matching. However, given the cross-sectional design, these associations should not be interpreted as causal relationships.