Effects of Health Risks Nudge Formal Long-Term Care Service Uptake of Older Adults: A Survey Experiment in China

OBJECTIVES: This study designed a randomised information intervention experiment aimed at assessing the impact of health risk information intervention of disability and dementia on formal LTC service intentions and willingness to pay among older adults.

METHODS: In August 2022, using stratified random sampling, we interviewed face-to-face 1142 nationally representative respondents aged 50-70 years across 8 provinces in China. All respondents were randomised into a control group (n=359), a disability information intervention group (n=441) and a dementia information intervention group (n=342). We employed logit and ologit models to examine the effects of the information intervention on formal LTC services intentions and willingness to pay, and analysed heterogeneity.

RESULTS: Health risk information intervention for disability and dementia significantly increased older adults’ formal LTC services intentions. Respondents in the control group without intervention were 50.43% willing to accept formal LTC services, with 88.89% and 84.21% after receiving the disability information intervention and dementia information intervention, respectively. Results of the heterogeneity analyses indicated that the nudge effects of disability information on formal LTC service uptake were stronger for the unhealthy, while the nudge effects of the dementia information intervention were stronger for those with low education and living in urban areas. Social knowledge showed a significant positive correlation with formal LTC service uptake. Social engagement showed a significant negative correlation with formal LTC service uptake. Moreover, the disability information intervention and the dementia information intervention significantly increased older people’s willingness to pay and willingness to accept formal LTC services, respectively.

CONCLUSIONS: These findings add to the empirical evidence promoting the uptake of formal LTC service intervention strategies for older adults. We recommend the government to implement targeted health risk education to promote formal LTC service uptake, especially for vulnerable groups such as the frail elderly and those with low educational backgrounds and urban residents.