FACTORS INFLUENCING HEALTHCARE SERVICES UTILIZATION AMONG THE ELDERLY BASED ON ANDERSEN BEHAVIORAL MODEL IN JIANGSU, CHINA, THE MODERATING ROLE OF INTER-GENERATIONAL SUPPORT

Abstract

The phenomenon of ageing has emerged as a significant issue in Jiangsu province, China, resulting in substantial societal and familial burdens. Chinese older individuals have the option to select between institution-based, community-based, and home care services. Nevertheless, the majority of them continue to rely on a pension system that is focused on staying at home, which places a significant strain on several Chinese households. This study aims to utilise the Andersen behavioural model, a widely-used framework in health care research, to examine the individual-level behavioural factors that influence older adults' willingness to use health care services. Specifically, the study will investigate the predisposing characteristics, enabling factors, and need factors that impact the utilisation of health care services among older adults. This research aims to investigate the moderating influence of inter-generational support, based on the embeddedness theory, in order to provide a more full understanding of the Andersen behavioural model, which previously overlooked this aspect. The empirical procedure used a quantitative research approach, namely using the stratified sample methodology. The association between variables in the existing conceptual framework is examined using Structural Equation Modelling (SEM) with AMOS. Specifically, Structural Equation Modelling (SEM) is conducted using Confirmatory Factor Analysis (CFA), a measurement model, and a structural model. As the moderator of the present study framework, we conducted a multi-group analysis in structural equation modelling (SEM) to examine inter-generational support. The statistical analysis showed that certain factors, such as health belief, individual-related resources, and perceived need, significantly influenced the intention of older adults in Jiangsu, China to choose institutional healthcare services. Inter-generational assistance has a detrimental effect on the connection between predisposing features and healthcare utilisation, between enabling resources and healthcare utilisation, and between need factors and healthcare utilisation.