To explore the impact of community-based long-term care (LTC) on self-rated and observer-rated health (ORH) among older adults in China.
Cross-sectional observational study using repeated cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (2011, 2014 and 2018).
Multivariate regression models were employed to examine the association between community-based LTC and both self-rated and ORH among older adults. Robustness was assessed using objective health indicators and alternative model specifications. Propensity score matching was used to minimise selection bias. Subgroup analyses were conducted by age, gender, living arrangement and urban versus non-urban residence.
Community-based LTC was significantly associated with higher self-rated health and higher ORH among older adults. Robustness checks using objective measures—such as hypertension and activities of daily living—and alternative analytic strategies confirmed these findings. The beneficial effects were more pronounced among women, those aged 75 and above, those living alone and urban residents.
Community-based LTC significantly improves both subjective and objective health outcomes among older adults in China. The effects are particularly strong for women, those aged 75 and above, those living alone and urban residents, highlighting the importance of targeting vulnerable groups.
Expanding and improving community-based LTC is essential for meeting the diverse needs of China's ageing population. These findings provide valuable insights for nursing professionals and health policymakers working to promote healthy ageing.
This study demonstrates that community-based LTC improves health outcomes among older adults in China. The results offer important guidance for nursing practice and health policy supporting healthy ageing, especially in rapidly ageing societies.
This study adheres to the STROBE guidelines for reporting observational studies.
This study did not include patient or public involvement in its design, conduct, or reporting.