Signing contracts for family doctors, functional limitations and home care willingness among older adults: a cross-sectional study.

Background: Traditional Chinese culture advocates home care be provided by family members. Home care can improve mental health and enjoy a familiar environment for older people. This study aimed to investigate the relationship between signing contracts for family doctors and home care willingness, as well as the interaction effect of functional limitations in this relationship.

Methods: This study was based on the sixth National Health Service Survey of Shandong province, China in 2018. A total of 8,055 older adults aged ≥ 60 years were included in the study. The logistic regression models were employed to examine the role of functional limitations in the relationship between signing contracts for family doctors and home care willingness.

Results: There were 6,891 (85.55%) participants had home care willingness in Shandong province, China. Compared to respondents who did not have family doctors, older adults with family doctors were more likely to report higher levels of home care willingness after adjusted for covariates (OR = 1.45, 95% CI: 1.27, 1.66). The interaction effect between signing contracts for family doctors and functional limitation on choosing home care for older adults was statistically significant (OR = 0.68, 95% CI: 0.47, 0.97).

Conclusions: The association between signing contracts for family doctors and home care willingness varies by functional limitations. Therefore, there is a need to improve social security system and family doctor service policy to suit the care needs of older people, especially those without functional limitations. Social care institutions should also provide comfortable care to disabled older adults as an effective complement.