Heterogeneity in Nursing Home Choice Preferences and Its Planning Implications: A Stated Preference Study in Shanghai

The mismatch between nursing home provision and older adults’ preferences has become a critical challenge for urban planning, yet limited attention has been paid to how different nursing home attributes are evaluated and whether such preferences vary across population groups. This study investigates heterogeneity in nursing home preferences and its planning implications through a stated choice experiment conducted among pre-elderly and older adults in central Shanghai, China. The analysis was based on 215 valid questionnaires and 2813 choice observations. A multinomial logit model was first employed to identify overall preferences for nursing home attributes, followed by panel latent class models to reveal heterogeneous preference patterns and examine their associations with demographic, socioeconomic, and family characteristics. The estimated preference parameters were further applied to evaluate 109 existing nursing homes in Pudong New Area from both overall and group-specific perspectives. The results indicate that location and healthcare accessibility are the two most influential attributes in the sample’s stated nursing home preferences, followed by care service quality, transportation accessibility, and air quality. However, substantial preference heterogeneity is observed across respondents. The joint latent class model identifies two preference classes: a trade-off class showing relatively moderate resistance to suburban locations and a location-anchored class exhibiting substantially stronger resistance to outer-suburban locations. Age is the most robust individual correlate of class membership, with older respondents more likely to belong to the location-anchored class. Living with children shows a weaker association, whereas gender, education, income, and number of children are not significant in the joint specification. The preference-based evaluation further demonstrates that existing nursing homes vary in their suitability across different preference groups. These findings highlight the importance of incorporating preference heterogeneity into nursing home planning and provide empirical evidence for improving the matching between institutional care supply and diverse care needs.