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BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on September 29, 2021 by guest. Protected copyright. BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018. Downloaded from Physical health, life satisfaction, social support and their effects on the willingness to receive eldercare among the elderly in urban and rural areas For peer review only Journal: BMJ Open Manuscript ID bmjopen-2017-020225 Article Type: Research Date Submitted by the Author: 24-Oct-2017 Complete List of Authors: Xing, Yanan; Harbin Medical University School of Public Health, Department of Health Management Pei, Ruijuan; Harbin Medical University School of Public Health, Department of Health Management Qu, Jing; Harbin Medical University School of Public Health, Department of Health Management Yan, Guanyun; Harbin Medical University School of Public Health, Marketing Management Zhou, Hao; Center for Disease Control and Prevention, Harbin , China, Department of Quality Control Liu, Xinyan; Harbin Medical University School of Public Health, Department of Health Management Zhang, Zhong; Harbin Medical University School of Public Health, http://bmjopen.bmj.com/ Department of Health Management Sun, Tao; Harbin Medical University School of Public Health, Wang, Zhaoqing; Harbin Medical University School of Public Health, Department of Health Management Li, Li; Harbin Medical University School of Public Health, Department of Health Management <b>Primary Subject Public health Heading</b>: on September 29, 2021 by guest. Protected copyright. Secondary Subject Heading: Health services research, Public health Physical health, Life satisfaction, Social support, Family eldercare, Keywords: Institutional eldercare For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 1 of 20 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018. Downloaded from 1 2 3 4 Physical health, life satisfaction, social support and their effects 5 6 on the willingness to receive eldercare among the elderly in urban 7 8 9 and rural areas 10 11 Yanan Xing#, Ruijuan Pei#, Jing Qu#, Guanyun Yan, Hao Zhou, Xinyan Liu, Zhong Zhang, Tao Sun, 12 13 Zhaoqing Wang, Li Li* 14 Yanan Xing：Department of Health Management, School of Public Health, Harbin Medical 15 For peer review only 16 University, Harbin, China email:[email protected] 17 Ruijuan Pei:Department of Health Management, School of Public Health, Harbin Medical 18 19 University, Harbin, China email:[email protected] 20 Jing Qu：Department of Health Management, School of Public Health, Harbin Medical University, 21 22 Harbin, China email:[email protected] 23 Guanyun Yan: Marketing Management, School of Humanities, Harbin Medical University, Harbin, 24 25 China email:[email protected] 26 Hao Zhou: Department of Quality Control, Center for Disease Control and Prevention, Harbin , 27 28 China email:[email protected] 29 Xinyan Liu: Department of Health Management，School of Public Health, Harbin Medical 30 31 University, Harbin, China email:[email protected] 32 Zhong Zhang:Department of Health Management，School of Public Health, Harbin Medical 33 http://bmjopen.bmj.com/ 34 University, Harbin, China email:[email protected] 35 Tao Sun: Department of Health Management, School of Public Health, Harbin Medical 36 37 University,Harbin, China, Email:[email protected] 38 Zhaoqing Wang:Department of Health Management，School of Public Health, Harbin Medical 39 40 University, Harbin, China email:[email protected] 41 Correspondence: on September 29, 2021 by guest. Protected copyright. 42 43 Dr, LI LI, School of Public Health, Harbin Medical University, Baojian Road 157, Harbin, 44 China,Tel: 86-451-87502879 Fax: 86-451-87502885 E-mail:[email protected] 45 46 #: These authors contributed equally to the work 47 48 49 50 51 52 53 54 55 56 57 58 59 60 1 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 2 of 20 BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018. Downloaded from 1 2 3 4 5 Abstract: 6 7 Purpose 8 9 The purpose of this article is to study the physical health, life satisfaction and 10 11 social support of the elderly, along with the effects of these aspects on the willingness 12 13 of eldercare, in urban and rural areas. The information will aid in our understanding of 14 15 the genuineFor needs ofpeer the elderly, soreview that we can provide only services that will ensure 16 17 comfortable and happy lives for them. 18 Methods 19 20 Sample data from Heilongjiang Province, China was used. A total of 1003 the 21 22 elderly were selected through multistage sampling. Data were processed with Epidata 23 24 and analyzed by SPSS 19.0. Descriptive statistics, chi-square, t-test, and logistic 25 26 regression analysis were used to measure the level of physical health, life satisfaction 27 28 and social support, as well as their effects on the willingness of eldercare among the 29 30 elderly in urban and rural areas. 31 32 Results 33 http://bmjopen.bmj.com/ 34 The results revealed that lots of the elderly would prefer family eldercare. The 35 percentage of the elderly who would prefer to have institutional eldercare is greater in 36 37 urban areas than in rural areas. Factors that influenced the willingness of eldercare for 38 39 the urban elderly were age, house property, and objective support. For the rural elderly, 40 41 having children, living alone, and having house property were associated with the on September 29, 2021 by guest. Protected copyright. 42 43 willingness of eldercare. 44 45 Conclusion 46 47 The elderly should be provided with more eldercare support and a platform for 48 49 efficient communication. For the elderly who are willing to choose institutional 50 51 eldercare, the government should provide some type of economic insurance and the 52 disposition of resources should be optimized according to the demand for institutional 53 54 eldercare. 55 56 Keywords: physical health; life satisfaction; social support; family eldercare; institutional 57 58 eldercare; 59 60 2 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 3 of 20 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018. Downloaded from 1 2 3 4 5 Strengths and limitations of this study 6 7 Made a comprehensive study that selected physical health, life satisfaction and social 8 9 support as the potential factors which may affect the willingness of eldercare. 10 11 Analysed the different factors influenced in the willingness of eldercare among the 12 13 elderly in urban and rural areas. 14 15 Used cross-sectionalFor peerdesign, data were review collected at only one only point in time. 16 17 Our participants were from a single province, and therefore, we cannot generalize the 18 19 results to assume that they apply to all of the elderly in China. 20 21 Introduction 22 The aging population has become one of the major social problems in the world. 23 24 In China, which is the largest developing country in the world, the trend of population 25 26 aging has become a serious issue [1]. By the end of 2015, 222 million are aged 60 27 28 years or older, which comprises 16.1 percent of the total population [2]. And there 29 30 were 40.63 million disabled elderly in China, which made up 18.3% of the aged 31 32 population.The problems associated with eldercare have become challenges for both 33 http://bmjopen.bmj.com/ 34 our government and society, since the aging population typically experiences an 35 36 increase in health problems. 37 Nowadays, the main way of eldercare was family eldercare and institutional 38 39 eldercare in China. Family eldercare refers the elderly live in home and receive care 40 41 from their families; institutional eldercare is when the elderly choose to live in an on September 29, 2021 by guest. Protected copyright. 42 43 institution that provides all of their care. 44 45 In recent years, increased geographic mobility and reduced family size due to 46 47 one-child policy have made more adult children unavailable for elder care [3]. In the 48 49 meanwhile, the traditional institutional eldercare service can not meet the high level 50 51 demands of the elderly for the quality of life. Therefore, the rational allocation of 52 53 eldercare resources and appropriate development of eldercare services has become 54 urgent problems. We should combine resources and explore various methods of 55 56 eldercare in order to meet the growing needs of this population. What’s more, we 57 58 59 60 3 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 4 of 20 BMJ Open: first published as 10.1136/bmjopen-2017-020225 on 31 May 2018.
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