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Utilizing consumer-directed care among older adults: Identifying barriers from behavioral economics perspectives

Zhang, Jinbao, Wang, Julia Shu-Huah, Chan, Wing Kit (2024) Utilizing consumer-directed care among older adults: Identifying barriers from behavioral economics perspectives. Research on Aging, 46 (5-6). pp. 275-286. ISSN 0164-0275. (doi:10.1177/01640275231226228) (KAR id:104568)


Consumer-directed Care (CDC) empowers older people to flexibly arrange services and enhances their well-being. Prior studies have suggested that limited attention and hassle costs are major demand-side barriers to using CDC. However, many other psychosocial factors were unexplored. In this study, we explore associations between CDC utilization and a wider range of psychosocial factors based on behavioral economics theories. A cross-sectional telephone survey of older persons (or family members that represent them) was conducted in Guangzhou, China in 2021. We adopted a two-stage sampling method based on administrative records and analyzed the data using multivariate logistic models. Procedural literacy, hassle costs, and social norms regarding CDC were associated with using CDC. The findings reveal nuances in the decision-making process, and people are not unboundedly rational in making care-related decisions. Policymakers could employ cost-effective tools to facilitate CDC utilization and optimize resources to address the most crucial service barriers.

Item Type: Article
DOI/Identification number: 10.1177/01640275231226228
Additional information: For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Subjects: H Social Sciences > HV Social pathology. Social and public welfare > HV1568 Disability studies
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Personal Social Services Research Unit
Funders: National Institute for Health Research (
Depositing User: Jinbao Zhang
Date Deposited: 10 Jan 2024 11:21 UTC
Last Modified: 02 May 2024 13:58 UTC
Resource URI: (The current URI for this page, for reference purposes)

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