Research On The Factors Influencing The Quality Of Community-based Elderly Care Services In Provincial Capital Cities

China has one of the fastest ageing populations in the world and 2022 will be the first year of accelerated ageing in China,with the number of people aged 60 and over set to exceed 300 million by the 14 th Five-Year Plan.Against the backdrop of the country’s positive ageing strategy,the community-based elderly care services in China’s cities have developed significantly,especially in the provincial capitals,which have achieved a high level of quality and have become a reference point for other cities and autonomous regions to improve the integrated construction of elderly care services.However,it should also be noted that the current structure of the elderly care model in China is 96% of the market share for home care,3% for community-based care and 1% for institutional care,which is still far from the "9073" project proposed by the National Health and Wellness Commission(i.e.90% for home care,7% for community-based care and 3% for institutional care).There is still a certain gap in the structure of the "9073" project proposed by the National Health and Wellness Commission(i.e.90% of home care,7% of community-based care and3% of institutional care).At the same time,the quality of elderly care services in 22 provincial capitals differs from one city to another.From the perspective of public value theory and service-oriented government theory,this paper constructs a framework for research on the quality of community-based home care based on the public value strategic triangle model,which consists of three primary indicators: "value objectives","operating conditions" and "legitimacy support",and further proposes six secondary evaluation dimensions on this basis,including the number of policies introduced,the number of elderly service institutions,the number of attendances of the disabled elderly,the number of elderly recreational institutions,the number of people participating in basic pension insurance and the number of various types of elderly beds.The study explored the pathways of quality community-based elderly care services and the core and marginal conditions in the pathways to optimise the quality of community-based elderly care services through Fuzzy-set Qualitative Comparative Analysis(fs QCA).The study found that high quality community care at home services are not generated by a single antecedent variable,but by a combination of multiple antecedent variables.The most important core condition for the generation of quality community-based home care services is the presence of a high number of elderly people with disabilities;based on this condition,there are two models for the generation of quality community-based home care services: ’infrastructure-based’ and’inclusive services-based’;With this core condition in place,the two models of "high number of policies + high number of elderly recreational institutions" and "high number of community aged-care institutions + high number of various types of beds" are substitutes for each other and can achieve the high-quality development of community aged-care services in a similar way.This study investigates the development of high quality community aged-care services.This study analyses typical cases of high-quality community-based elderly care services and makes suggestions for optimisation,including improving the construction of beds for the elderly with disabilities and promoting the shift of the focus of elderly care institutions to the community.The study is useful in accelerating the construction of an integrated elderly care service system coordinated by the government,communities,social organisations,elderly care institutions and the elderly being served,and provides good practical insights for the sound promotion of the development of community-based medical and nursing care models,meeting the needs of inclusive and personalised elderly care,improving the effectiveness and sustainability of elderly care,improving the construction of service-oriented government and enhancing the construction of public values of the government.It also provides good practical insights to improve the construction of a service-oriented government and enhance the construction of public values.