Can improved community-based elderly care services reduce fall risks among disabled older adults? evidence from China

As the second leading cause of unintentional injury-related deaths worldwide, falls represent a critical public health concern for governments, societies, and academic communities alike. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) covering 2011 to 2020, this study employs a difference-in-differences (DID) model to examine how improvements in home and community-based care services influence fall risks among disabled older adults and to uncover the underlying mechanisms. The empirical results indicate that the improvement of these services significantly lowers fall risks, primarily through the optimization of daily living assistance and the enhancement of health management. Heterogeneity analyses further show that the positive effects are more pronounced among older adults not living with their children and those residing in rural areas. These findings suggest that policymakers should pay greater attention to the negative consequences of unmet or insufficient care services on fall risks, continue to advance the integration of medical and elderly care within communities, and strengthen ‘soft’ service support to buffer health- and activity-related fall risks among older adults.