Impacts of Community- and Home-Based Elderly Care Services on Eldercare Patterns: A Quasi-Experimental Study in China

China's rapid population aging and eroded family support capacity have heightened demand for sustainable eldercare solutions. To improve the capacity and quality of socialized eldercare services, China has initiated the community- and home-based elderly care services (CHECS) pilot program in 203 regions. This study explores its impact on older adults' care patterns, aiming to address the need for effective eldercare approaches amid demographic and social changes. This study followed a quasi-experimental design and derived longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) for 2011 to 2020. We employed a staggered difference-in-differences (DID) approach to evaluate the effects of the CHECS pilot on older adults' eldercare patterns across 5 key dimensions: living arrangements, care arrangements, economic sources, consumption expenditures, and spiritual comfort. The CHECS pilot significantly influences older adults' care patterns across multiple dimensions. It increases the likelihood of hiring social personnel for care, reduces financial dependence on children, enhances financial self-sufficiency, and raises medical consumption expenditures. However, it decreases contact frequency with non-cohabiting children and does not affect living arrangements. These findings remain consistent across various tests. Notably, heterogeneous analysis shows stronger effects in regions with higher pension burdens and among vulnerable groups. Furthermore, CHECS also promotes greater use of community healthcare/eldercare services and shifts older adults' perspectives on eldercare responsibilities. The implementation of the CHECS pilot significantly reshapes eldercare patterns in China across various dimensions, including care arrangements, economic resources, consumption expenditures, and spiritual comfort. CHECS demonstrates a viable, community-centered solution to aging and declining family support, offering an adaptable model for countries with similar eldercare pressures.