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ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 |
doi: 10.3389/fpubh.2025.1535987
This article is part of the Research Topic Caregiving for Older Adults in Rural and Underserved Communities View all articles
Bridging Accessibility Gaps in Urban Community-Based Basic Elderly Care: A Comprehensive Framework Validated in Xi'an, China
Provisionally accepted- 1 Northwest University, Xi'an, China
- 2 Xi'an University of Architecture and Technology, Xi'an, Shaanxi Province, China
Objectives: Accessibility is a critical factor in ensuring equitable public services. In urban elderly care systems, resource allocation and service disparities present unique challenges.The classical "5A" theoryavailability, accessibility, affordability, adaptability, and acceptabilityprovides a robust framework for evaluating service delivery. However, its application in urban elderly care, especially in rapidly aging societies like China, remains limited. This study aims to develop and validate a framework to address affordability, resource allocation, and service mismatches in urban elderly care systems.Methods:A web-based cross-sectional study was performed in 2023. A multi-phase methodology was adopted to construct the framework, grounded in the " 5A " theory. Indicators were refined through expert consultations using the Delphi method, involving 20 experts, while the entropy weight method ensured objective indicator weighting. The framework was empirically validated in Xi ' an, China, using survey data collected from 438 elderly residents across urban strata. A fuzzy comprehensive evaluation (FCE) method was employed to assess accessibility and identify key service gaps.Results:This study constructs a comprehensive evaluation framework for basic elderly care services (BECS), structured around 5 primary dimensions, 14 secondary indicators, and 37 tertiary indicators.Empirical validation in Xi ' an further demonstrates the framework ' s scientific rigor and practical applicability. While the framework identifies strong spatial accessibility (3.8815), it also reveals critical gaps in affordability (3.1347) and psychological care (3.0862), confirming its effectiveness in diagnosing systemic disparities and guiding policy interventions.Conclusions:This study introduces a novel accessibility evaluation framework tailored for basic elderly care services, addressing critical gaps in affordability, psychological care, and service responsiveness. Empirical results validate the framework's practicality and its alignment with the real-world conditions of urban aging societies. Furthermore, an innovative " Matching-Realization-Satisfaction " improvement pathway is proposed, offering actionable strategies to enhance
Keywords: accessibility, Basic elderly care, Urban community, evaluation framework, Service equity
Received: 28 Nov 2024; Accepted: 04 Feb 2025.
Copyright: © 2025 Zhang, Zhou, Hu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuyuan Zhang, Northwest University, Xi'an, China
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