The Influence of Home and Community‐Based Services Program on Healthcare Utilization Among Older Adults in China.

The Chinese government launched the Home and Community‐Based Services (HCBSs) pilot program in 2016 to tackle the unmet care needs of the aging population. This study seeks to evaluate the association between HCBS usage and healthcare utilization and to examine whether this relationship is influence...

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Publicado en:Health & Social Care in the Community Vol. 2025; pp. 1 - 12
Autores principales: Su, Qing, Zhong, Jing, Zhang, Wenjuan, LeBlanc, Raeann
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell 11/27/2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The Influence of Home and Community‐Based Services Program on Healthcare Utilization Among Older Adults in China.
      aug:
        au:
          Su, Qing
          Zhong, Jing
          Zhang, Wenjuan
          LeBlanc, Raeann
        affil: School of Population and Health,, Renmin University of China,, 59 Zhongguancun St, Beijing, 100872,, China, ruc.edu.cn
      sug:
        subj:
          Home Health Care Utilization
          Community Health Services Utilization
          Health Services for Older Persons Utilization
          Sex Factors
          Program Evaluation
          Patient Attitudes
          Human
          Funding Source
          China
          Male
          Female
          Middle Age
          Aged
          Prospective Studies
          Chinese Persons
          Probability Sample
          Nonexperimental Studies
          Quasi-Experimental Studies
          Community Health Nursing
          Government Programs
          Health Services Needs and Demand
          Aging
          Outpatients
          Retirement Planning
          Health Care Costs
          Stakeholder Participation
          Readmission
          Risk Assessment
          Healthcare Disparities
          Pilot Studies
          Health Policy
          Emergency Service
          Preventive Health Care
          Urban Health Services
          Rural Health Services
          Questionnaires
          Descriptive Statistics
          Comparative Studies
          Gerontologic Nursing
          Data Analysis Software
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: The Chinese government launched the Home and Community‐Based Services (HCBSs) pilot program in 2016 to tackle the unmet care needs of the aging population. This study seeks to evaluate the association between HCBS usage and healthcare utilization and to examine whether this relationship is influenced by place of residence and gender. We used data from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study and applied propensity score matching with difference‐in‐differences (PSM‐DID) to investigate the link between HCBS usage and healthcare utilization. The final sample comprised 9280 older adults. Findings revealed a significant positive association between HCBS usage and the number of outpatient visits in the past month (β = 0.031, p < 0.05), outpatient out‐of‐pocket (OOP) expenditure (β = 0.223, p < 0.01), and total outpatient expenditure (β = 0.220, p < 0.01). However, HCBS usage showed no association with the number of hospitalizations in the past year, inpatient OOP expenditure, or total inpatient expenditure (all p > 0.05). Heterogeneity analysis indicated that the urban–rural background significantly moderated the association between HCBS and inpatient care, while these associations between HCBS and healthcare utilization did not vary by gender. Policymakers should prioritize integrating HCBS with healthcare services when designing and implementing healthcare and HCBS policies to optimize resource utilization and improve service efficiency. Moreover, additional efforts are warranted to ensure the equitable distribution of HCBS and healthcare resources between urban and rural areas.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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