The impact of digital literacy on older adults’ utilization of community-based home care services: a cross-sectional study

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BACKGROUND: China has entered a stage of moderate aging, characterized by a "90-7-3" eldercare pattern: 90% of the older adults opt for home-based care, 7% utilize community-based care, and 3% reside in institutional care facilities. With the rapid development of the digital economy, innovative solutions such as smart eldercare devices and telemedicine have emerged, offering new possibilities to enhance the efficiency and quality of eldercare services. However, while benefiting from digital technologies, the older adults generally face challenges posed by the "digital divide," making digital literacy a critical factor constraining the digital transformation of eldercare services. METHODS: This study utilizes data from the 2020 China Longitudinal Aging Social Survey (CLASS 2020) to examine the impact of digital literacy on older adults' utilization of community-based home care services (CHCS). Factor analysis was employed to measure digital literacy levels, while probit regression and Heckman's two-stage model were applied for empirical analysis. CONCLUSION: Our empirical analysis yields three key findings: (1) A significant negative relationship is found between digital literacy and the utilization of CHCS. This indicates that, on average, higher digital literacy is associated with a lower propensity to use CHCS. (2) Dimension-specific analysis reveals divergent impacts: Digital application literacy was positively associated with service utilization. However, device operation literacy, information acquisition literacy, and digital social literacy all exhibited significant negative correlations with service use. (3) Mechanism analysis indicates that digital literacy reduces older adults' reliance on CHCS through multiple pathways, including increased alternative consumption expenditures, strengthened social and family support, and improved self-efficacy. DISCUSSION: The findings suggest that improved digital literacy may reduce older adults' utilization of CHCS, providing important implications for optimizing the elderly care system in the digital era. While promoting digital literacy among older populations, policymakers should establish integrated online-offline service delivery models to achieve precise matching between seniors' needs and care provision.

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