41 4 2017 7 Vol. 41 No. 4 July 2017 46 Population Research * 2014 CLHLS 3 200433 Determinants of Long-Term Care Services among Disabled Older Adults in China A Quantitative Study based on Andersen's Behavioral Model Peng Xizhe Song Liangjun Huang Jiankun Abstract This paper employs the Andersen's Behavioral Model as the theoretical framework to analyze the determinants of utilization of formal long-term care service including the home /communitybased LTC and institution-based LTC using the dataset of CLHLS 2014 in China. The logistic regressions show that the enabling and need but not the predisposing factors are significant determinants of formal LTC use in China. The Paper further argues that the long-term care service utilization in the Chinese context is subject to the social-culture environment the importance of which is highlighted. In addition we have modified the Andersen's Model for LTC use by adding the willingness of family caregivers as the cultural factors based on the Chinese socioeconomic situation. The paper concludes with discussions on the assessment of LTC the capability development of family and the future trends of community-based service. Keywords Disabled Older Adults Long-term Care Andersen's Behavioral Model Ageing Authors Peng Xizhe is Professor Center for Population and Development Policy Studies Fudan University Email xzpeng@ fudan. edu. cn Song Liangjun is PhD School of Social Development and Public Policy Fudan University Huang Jiankun is Master Student School of Social Development and Public Policy Fudan University. * 71490735
4 47 1 1. 1 2011 1 1 1. 2 Long-Term Care Pratt JR 2004 2008 2014 2007 Choi M. et al. 2010 ADL IADL 1 60 10% 65 7% 65 14. 3% 65 21. 2% 2015 2015 65 1. 44 10. 5%
48 41 Wallace S. P. et al. 1998 2007 2015 2014 Crist J. D. 2002 2005 2014 1 2016 2010 2 2013 2014 2008 2014 2014 2016 3 Andersen's Behavioral Model 2015 2014 2014 2 2. 1 2014 CLHLS 22 7110 65 ADL 6 6 1 90 1056 2. 2 6 0-1 0 1
4 49 Multinomial Model Van Campen C Van Gameren E 2005 Ordered Response Model de Meijer et al. 2009 Chen-Yi Wu et al. 2014 2014 CLHLS 3 1 a 65 ~ 79 80 b c 3 d 2 a b c d e f g h i 3 a 24 b 6 6 1 5 1 4 1 3 1 2000 1 2. 3 1056 6. 42% 82. 29%
50 41 64 30 80 57. 18% ADL 37. 18% ADL 2015 84. 53% 15. 47% 82. 81% 10 1 1 Table 1 Characteristics of Variables % % 84. 53 15. 47 17. 71 82. 29 65 ~ 79 42. 82 8000 24. 96 80 57. 18 25000 24. 91 50000 28. 37 35. 33 50000 21. 75 64. 67 41. 97 56. 85 25. 65 43. 15 32. 37 21. 81 38. 93 78. 19 61. 07 80. 96 19. 04
4 51 % % 66. 48 57. 74 33. 52 42. 26 0 75. 73 72. 38 1 23. 16 27. 62 2 1. 08 3 0. 03 73. 05 26. 95 0 93. 37 1 5. 83 39. 83 2 0. 80 22. 99 6 0. 01 37. 18 90. 97 9. 03 1 2 3 100% 2. 4 Logistic 0 1 p p / 1 - p odds p 1 logit f p = ln ( 1 - p) f p = α + βx + ε X ε 3 1 2 3 1 f 1 p = α 1 + β 1 1X + ε 1 2 f 2 p = α 2 + β 2 1X + β 2 2X + ε 2 3 f 3 p = α 3 + β 3 1X + β 3 2X + β 3 3X + ε 3 3 Logistic 2 *
52 41 Table 2 2 Logistic Regressions of Long-term Care Use OR 1 2 3 65 ~ 79 80 0. 27 ** 0. 53 0. 62 0. 73 1. 91 1. 78 4. 17 * 2. 91 ** 3. 00 * 3. 60 ** 4. 19 ** 5. 89 ** 1. 14 2. 54 ** 1. 87 10. 38 *** 6. 29 ** 8000 25000 0. 29 0. 19 ** 50000 0. 71 0. 28 ** 50000 15. 21 *** 7. 23 *** 14. 76 *** 10. 59 *** 0. 06 *** 0. 10 *** 14. 46 *** 19. 30 *** 0. 32 * 0. 34 * 0. 02 *** 0. 02 *** 0. 07 ** 0. 08 *** 2. 62 4. 24 * 0. 21 ** 0. 74 0. 22 ** 0. 87 0. 42 1056 1056 1056 * p < 0. 1 **p < 0. 05 ***p < 0. 01
4 53 4 4. 1 3 R 3 70% 3 2 1 R AIC BIC 2 R 1 2 3 Table 3 3 Measures of Fit for Logit Models 1 2 3 R 2 0. 140 0. 648 0. 696 Adj R 2 0. 080 0. 482 0. 477 AIC 0. 294 0. 166 0. 167 AIC* n 310. 722 175. 108 176. 600 BIC - 6991. 785-7038. 078-6991. 926 BIC' - 12. 366-107. 395-89. 091 1 Figure 1 1 Predictive Margins of Education U
54 41 U 2 2 Figure 2 Predictive Margins of Income 2. 5% 2013
4 55 4. 2 4. 2. 1 ADL Katz 1950 ADL / / / / ADL IADL WHO ADL /IADL ADL WHO ADL WHO ICF 1 1 2001 5 22 54 International Classification of Function Disability and Health ICF World Health Organization 2001
56 41 4. 2. 2 85% / 40% 1 5 4. 2. 3 1 FYRST 2016
4 57 1996 ~ 2006 79% 61% 21% 39% 1995 44% 5 ADL ICF 1 2014 causality 2
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