Equity in public decision-making: a dynamic comparative study of urban–rural elderly care institution resource allocation in China

Abstract

Abstract As the aging population creates mounting pressures on society, the economy, and public health systems, the rational and equitable distribution of elderly care resources becomes increasingly essential. This study applies various methods, such as kernel density estimation, spatial autocorrelation analysis, and Gini coefficient decomposition, to examine provincial panel data on elderly care institutions in both urban and rural regions in China covering the period from 2008 to 2021. This research seeks to assess and improve the accessibility and equity of elderly care resources. The results indicate that the degree of population aging in China has significantly intensified, with urban elderly care institutions’ resource allocation increasing annually and surpassing that of rural institutions. However, inequalities in the allocation of elderly care resources between urban and rural areas, as well as among different regions, still exist. The uneven distribution of resources in rural elderly care institutions, the overall enhancement of resource allocation in urban areas, and the clustering of elderly care resources are the key features observed. Drawing on these insights, the study offers a set of policy recommendations to address the disparities and inconsistencies in the allocation of elderly care resources between urban and rural regions.