Who cares and who pays? Financial sources and care preferences among older adults in China

China's rapid population aging challenges traditional family-based care arrangements. This study examines heterogeneity in home-based care preferences by assessing how financial support sources, number of children, and children's gender composition are associated with care preferences among older adults in Southwestern China.

Data were drawn from the 2023 Chengdu-Chongqing Economic Circle Social Dynamics Survey. The analytic sample included 1,812 adults aged 50 years and older with children. Multinomial logistic regression models estimated associations between financial resources, family structure, and 4 care preference categories: self/spousal home care, child-provided home care, mixed family care at home, and other arrangements.

Financial reliance patterns were strongly associated with care preferences. Dependence on adult children for financial support was associated with a higher likelihood of preferring child-provided care, with this association stronger among women than men. Children's gender composition was not significantly associated with care preferences. Larger family size (four or more children) was associated with mixed family care preferences.

These findings suggest that financial resources may play a more prominent role than children's gender in shaping care preferences in this population. Women's greater reliance on children is consistent with gendered economic disadvantage in later life. Policies that strengthen pension adequacy and support diverse home-based care arrangements may help address evolving care needs.