Bringing Care Closer: The Health Benefits of Home- and Community-Based Services Policy for Older Adults in China

As global populations age and demand for diverse eldercare services grows, ensuring accessible, high-quality care has become central to promoting older adults’ health and well-being. Drawing on five waves of panel data from the China Health and Retirement Longitudinal Study (2011–2020), this study uses the staggered rollout of China’s HCBS pilot reform beginning in 2016 as a quasi-natural experiment and applies a multiperiod difference-in-differences (DID) approach to examine its effects on older adults’ subjective and objective functional health. The results show that the HCBS policy significantly improves subjective and objective functional health, with estimated effects of 0.093 and 0.106, respectively. Mechanism analyses suggest that these health gains are associated with lower disease risk, changes in household consumption, and the reallocation of family resources. Heterogeneity analysis shows that both health outcomes improve significantly among adults aged 60–69 and urban residents, whereas additional improvements in subjective health are observed among high-income households and residents of developed cities. These findings support strengthening HCBS capacity, improving healthcare–eldercare integration, and promoting more equitable access to community-based services.