The impact of community-based home care service utilization on intergenerational family support: enhancement or attenuation?

Abstract

Introduction – As population aging intensifies, elder care has emerged as a central issue affecting socioeconomic sustainability, social harmony, and stability. The coordinated development of social care and family-based care has become pivotal to addressing the challenges of elder care. The rise of community-based home care services, while bridging gaps in family-provided care, has also exerted far-reaching effects on intergenerational family support. Therefore, examining the impact of community-based home care service utilization on intergenerational family support carries significant implications for addressing the elder care challenge. Methods – Drawing on data from the 2020 Chinese Longitudinal Aging Social Survey (CLASS) and given the ordinal nature of the dependent variables, this study employs an ordered Probit model, instrumental variable estimation (IV ordered Probit), and propensity score matching (PSM) to examine the effect of community-based home care service utilization on intergenerational family support. Results – Community-based home care service utilization significantly promotes intergenerational economic support, yet has a crowding-out effect on intergenerational instrumental and emotional support. Moderation analysis reveals that co-residence with adult children mitigates the adverse effects of community-based home care service utilization on intergenerational instrumental and emotional support. Heterogeneity analysis indicates that the negative effects on intergenerational instrumental and emotional support are primarily concentrated among urban households, with no statistically significant effect observed among rural households. In contrast, the positive effect on intergenerational economic support is more pronounced in urban households. Discussion – This study provides empirical evidence for understanding the relationship between community-based home care services and intergenerational family support. It delineates the differentiated effects and heterogeneous characteristics of community-based home care service utilization across distinct types of intergenerational support, yielding important policy implications for optimizing the elder care service system and fostering the coordinated development of social care and family-based care.