Influencing Factors of the Long-term Care Needs of Disabled Elderly People in Urban and Rural Areas in China

Abstract

As the population ages, the long-term care needs of elderly people with disabilities are becoming increasingly urgent. This study examines urban-rural differences in long-term care needs and their key determinants among older adults in China. Using data from the 2020 China Health and Retirement Longitudinal Study, we analyzed a sample of 8,533 individuals aged 60 and above with disabilities. A generalized ordered logistic regression model was applied to both the full sample and urban-rural subsamples. Results show that individuals aged 80 and above and those with four or more chronic diseases have significantly higher care needs, while better self-assessed health is associated with lower demand. Rural elderly individuals exhibit greater long-term care needs than their urban counterparts, especially those aged 80 and above, whose needs are 1.23 times higher. Chronic disease has a stronger effect on care needs in rural areas, and the protective effects of education and social participation are weaker. These findings highlight the importance of age, health status, and chronic disease burden in shaping long-term care demand and underscore significant urban-rural disparities. It is recommended that long-term care insurance be integrated into basic medical systems, prioritizing coverage for severely disabled rural populations and gradually expanding to include those with mild to moderate disabilities.