The Evolution, Logic, and Prospects of Community-Based Home Elderly Care Policies in China: An Analysis based on Historical Institutionalism

Abstract

In response to the pressing issue of population aging and the increasing demand for elderly care services in China, a series of community-based home elderly care policies have been implemented. Utilizing a historical institutionalism analytical framework, this study categorizes the evolution of these policies into four distinct historical stages: emergence due to circumstances, exploratory initiation, clear acceleration, and quality enhancement. Based on structural and historical perspectives, this analysis summarizes the institutional context and policy establishment, the political variables and structural interaction, the key nodes and institutional breaks, as well as path dependence coupled with gradual transformation. Looking ahead, there is a need for community-based home elderly care policies to advance in four key areas: expanding coverage and diversifying services, enhancing informatization and intelligence, fostering marketization and socialization, and promoting integration and specialization, thereby improving institutional synergy to address the increasingly complex needs of the elderly population.