Provision and Utilisation of Community Care Services in Beijing, China.

"Ageing in place" is the preferred choice for the majority of older persons in China, and community care services support them in living in their homes as long as possible. Based on statistics, interview data, and policy documents, this study analyses the provision and utilisation of community care facilities in Beijing by conducting spatial and qualitative analysis based on structuration theory. The mapping and spatial analysis reveal spatial inequity in the allocation of community care facilities in Beijing, which increased from 494 in 2017 to 1,201 in 2020. Communities in suburban areas, where the older population is growing the fastest, have poorer spatial accessibility to community care services than those located in the central city. Qualitative analysis based on interviews with 28 older residents in six communities, and six managers and staff members of community care facilities, revealed high demands for community care services including daily life support, emotional support, and healthcare services, with low utilisation of the services and many challenges for service provision. Poor perception and evaluation of the services by older persons result in low utilisation of the services. Financial difficulties in service provision and limited support from the government are the major challenges reported by the managers. Strategies have also been developed to meet these challenges by the older persons and managers. Text analysis of policy documents shows the development of regulations and policies on the construction, support, and quality management of the community care system. The complex dynamics of interaction between structure and agency in resource allocation and daily practice of service delivery shapes the provision and utilisation of community care services as a relatively new mode for aged care in China. The findings support understanding the challenges of community care service provision and utilisation from a health geography perspective. Joint efforts from local governments, communities, the private sector, and older residents are needed to support ageing in place in Beijing. [ABSTRACT FROM AUTHOR]