Valuation of informal care for the old-aged with disabilities in China: a discrete choice experiment approach

Background: The rapidly aging population will lead to a surge in demand for long-term care services in China. Reinforced by the cultural norms, and with inadequate nursing resources and social care facilities, long-term care in China is primary the responsibility of the immediate family. Despite the central role of family caregivers, little is known about their preferences and how they value different types of caregiving tasks. This study provides new evidence on the economic valuation of informal care in the Chinese context. Methods: Discrete choice experiment (DCE) and mixed logit models (MXL) were employed to measure the preferences for an economic value of different types of informal care (daily care, medical care and companion care) among old-aged adults in China. 466 participants from nationwide were recruited and interviewed. Results: Among the respondents, 19.5% always chose to receive the free care package and 15.2% always chose to obtain cash compensation for informal caregiving. Of the three care tasks, participants placed the highest value on daily care (RMB48.202 ($13.26 PPP) per hour) and the lowest value on companion care (RMB18.608 ($5.12 PPP) per hour). The probability of choosing cash compensation rose when compensation increased and fells when the care time increased. The preferences for assistance varied significantly by individual’s demographic and health-related characteristics. Female respondents preferred for care packages relative to males; farmers and current caregivers preferred cash compensation; married participants had low preferences for companion care; participants from western region had low preferences for medical care. Discussion: Our findings confirm the importance of cash compensation in retaining caregivers to provide informal care. The heterogeneity of preferences among different groups is significantly influenced by their sex, occupation, caregiving, marital status and region. Our study supports the promotion of cash compensation to informal caregivers and different levels of incentives for different groups of informal caregivers.