Spatial equity and factors that influence the distribution of elderly care institutions in China

中国养老机构分布的空间公平性及影响因素

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Abstract

BACKGROUND: With China becoming an aging society, the number of elderly care institutions (ECIs) is continuously increasing in response to the growing population of older persons. However, regional disparities may lead to an uneven distribution of ECIs, which could affect equity in care. This study identified the limiting factors in the development of ECIs across different regions, thereby promoting equity in accessing care for the older population. METHODS: This study utilised point-of-interest data on ECIs in China from 2018 to 2022. The spatiotemporal distribution of ECIs and the causes of disparities were assessed along four dimensions-economy, population, society, and environment-using research methods such as the standard deviation ellipse, rank-size rule, and multiscale geographically weighted regression. RESULTS: There were significant differences between the ECIs of the eastern and western regions in China. The eastern region had a denser distribution and higher concentrations in primary cities. The proportion of the older population, regional economic development, and household income are crucial for a balanced distribution of ECIs, whereas the environmental impact is relatively minor. CONCLUSIONS: The number of ECIs in China continues to increase, but improvements in regional disparities remain insignificant. The construction of ECIs is influenced by various factors; in underdeveloped regions, government initiatives are crucial for promoting equity in care for older persons.

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