How Marketization Vulnerabilities Shape Low Occupancy in China’s Continuing Care Retirement Communities: A Five-Project Case Study

Continuing Care Retirement Communities (CCRCs) in China have long exhibited low occupancy rates, revealing critical vulnerability in the marketization of care services for older adults. However, a limited number of studies have explored the complex interrelationships among them. This study employed a case study design, selecting five typical CCRC projects to investigate the vulnerability in the marketization of care services for older adults in China and their impact on low occupancy rate of CCRCs. Thematic analysis identified four core themes with eight sub-themes: (1) Blurred boundaries between public basic care services and market-oriented social care services prevented the government from properly positioning CCRCs as non-basic care facilities, resulting in excessive policy support for them; (2) Insufficient understanding of market mechanisms and associated risks rendered the government overly optimistic about CCRCs and results in inadequate supervision; (3) Under a loose institutional framework, CCRCs prioritized profit. Developers were reluctant to run small-scale projects and strove to maximize economic gains; (4)This led to a mismatch between CCRCs and the demands of older adults. Publicity was merely marketing gimmicks and services lacked sufficient appeal. These interconnected issues have collectively contributed to low occupancy rates and the ineffective delivery of CCRCs in China. The study recommends that the government clearly delineate its responsibilities in the care services and remain vigilant to potential risks in the marketization of care services. Its purpose is to provide valuable insights for other countries that are experiencing the upsurge of CCRCs construction and promoting the marketization of care services.