Frontiers in Business, Economics and Management ISSN: 2766-824X | Vol. 21, No. 2, 2025 90 The Development Status, Issues, and Countermeasures of Home-Based Elderly Care Services: A Case Study of Anhui Province Shiyi Wang, Yuting Ruan * School of Finance and Public Administration, Anhui University of Finance and Economics, Bengbu, China * Corresponding author: Yuting Ruan (Email: 20232832@aufe.edu.cn) Abstract: With the acceleration of population aging, home -based elderly care has become the foundation of China's elderly care service system. As a province with a high aging rate and uneven development, Anhui's home -based elderly care service institutions are highly representative. Based on reviewing relevant theories and literature, this study explores the current development of home-based elderly care service institutions in Anhui through case analysis and policy text analysis. It delves into the practical challenges they face, such as mismatched supply and demand of services, a shortage of professional talent, and weak sustainable operational capacity. Accordingly, targeted optimization pathways and countermeasures are proposed to provide theoretical references and practical insights for improving regional home-based elderly care service systems. Keywords: Home-based elderly care; Service agencies; Anhui Province; Aging; Elderly care service supply. 1. Introduction China is currently experiencing the largest and fastest population aging process in the world. The 14th Five Year Plan clearly proposes to build a coordinated elderly care service system that combines home and community institutions with medical care, elderly care, and health care. Among them, the fundamental position of home -based elderly care is increasingly prominent. As the core carrier of service delivery, the development quality of home -based elderly care service institutions directly affects the qual ity of life of the vast majority of elderly people in their later years. Anhui Province, as a populous province in central China, faces a severe aging situation. According to data from the Anhui Provincial Bureau of Statistics, as of the end of 2022, the elderly population aged 60 and above, and 65 and above in the province were 12.16 million and 9.88 million respectively, accounting for 19.85% and 16.15% of the total permanent population. The degree of aging has exceeded the national average level and shows characteristics of aging and empty nest. In this context, vigorously developing home - based elderly care services to meet the elderly's need to stay at home and in the community has become an urgent task for Anhui Province to address population aging. Domestic and foreign scholars have conducted beneficial explorations on the development strategies of home -based elderly care. Community home-based elderly care, as the core model for addressing population aging in China, has become a focus of academic research in terms of its development trends, challenges, and optimization paths. Existing research has conducted in-depth exploration from dimensions such as pattern coordination, digital transformation, data governance, and multi-party cooperation. Liu Hao et al. (2025) [1] found through empirical research that the coupling coordination degree between home-based community elderly care and institutional elderly care in China showed an upward trend from 2018 to 2022, and the coordination area expanded from the central and eastern regions to the western an d northeastern regions, indicating that the integration level of the elderly care service system is gradually improving in space. The study further points out that organizational strength, elderly care needs, and technological level are key influencing fac tors in promoting the coordinated development of the two models. The deepening development of community -based elderly care is facing structural challenges of digital transformation. Liu Xinxin and Liu Xiaoyun (2025) [2] pointed out that this transformation is not simply a combination of technology, but follows a systematic process of "technology embedding factor leap structural adjustment functional emergence". Currently, it still faces multiple challenges such as digital divide, technological disconnection, factor constraints, and institutional constraints. Among them, the "digital divide" is the primary obstacle facing transformation. Xueqing Xia and Mingbao Zhu's (2025) research confirms that the digital literacy level of the elderly directly restricts th eir utilization of community home-based elderly care services, which is a key limiting factor for digital transformation. To tackle the data challenges in the digital transformation, scholars have proposed specific technical and institutional solutions. Dong Yan and Liu Shijie (2025) [3] proposed a solution for data silos and information security risks in smart home care, advocating for public data authorization operations. They proposed clarifying the government's data collection and authorization subject status in the system, and using federated learning and blockchain technology in technology to balance the efficiency and security of data sharing. In addition, meeting the diverse and multi-level needs of the elderly is the fundamental starting point for service development. Zhou et al. (2025) [6] conducted a study based on the modular design concept, which showed that the needs of the elderly cover five dimensions: life assistance, medical care, spiritual culture, rights protection, and aging adaptation. Among them, spiritual and cultural services and aging adaptation are the most urgent, and specific groups such as the elderly and those living alone have higher demand intensity, which requires service supply to move towards refinement. In terms of service supply mechanism, Zhang Ping (2018) [4] starts from the theory of new public management and analyzes the PPP 91 model, emphasizing that the government and social capital must establish a collaborative cooperative relationship, and reasonably design the rights and responsibilities relationship, investment return mechanism, and quality evaluation system to enhance the effectiveness of service supply. However, while the home-based elderly care service institutions in Anhui Province are rapidly developing, they have also exposed many deep -seated problems. Therefore, this study takes Anhui Province as the specific research object, systematically examines the development status of its home- based elderly care service institutions, accurately identifies the challenges it faces, and proposes practical and feasible development strategies. This not only has practical significance for the healthy development of Anhui Province's own elderly care industry, but also has important reference value for similar regions across the country. 2. Theoretical Basis and Literature Review 2.1. Theoretical Basis (1) Positive aging theory: The World Health Organization proposes to optimize the quality of life of the elderly from the three dimensions of "health, participation, and security", providing theoretical guidance for the development of home - based elderly care services from basic life care to promoting higher levels of social participation and spiritual comfort for the elderly. (2) Welfare pluralism theory: advocates that welfare supply should be jointly undertaken by multiple entities such as the state, market, family, and community. This theory provides an analytical framework for analyzing the role positioning and cooperation models of government, enterprises, social organizations, and families in home-based elderly care services. 2.2. Literature Review Elderly Care Services The current research on community -based home-based elderly care services presents multidimensional and systematic characteristics, significantly deepening our understanding of this field. On the one hand, research is more accurate in problem diagnosis. Zho u et al. (2025) accurately identified the five dimensions of elderly people's needs and their intensity differences through modular design; On the other hand, the analytical perspective is more systematic. The digital transformation mechanism framework con structed by Liu Xinxin and Liu Xiaoyun (2025), as well as the spatiotemporal analysis of the coupling and coordination relationship between home-based and institutional elderly care by Liu Hao et al. (2025), have elevated the research from local optimization to the level of system ecology and global pattern. In addition, the public data authorization operation proposed by Dong Yan and Liu Shijie (2025) and the exploration of PPP model by Zhang Ping (2018) indicate that the construction of solutions also ten ds towards a feasible path that combines institutions and technology. However, existing research still has some inherent limitations and gaps. Firstly, there is a tendency to prioritize supply over experience in terms of perspective. Most studies focus on the supply side, such as service models and technology applications, while there is a relative lack of in- depth qualitative research on the micro subjective experiences and behavior change mechanisms of elderly people as service recipients. Secondly, research methods mainly rely on cross- sectional analysis, lacking longitudi nal tracking and evaluation of the long-term effects and causal effects of innovative practices such as logarithmic transformation and PPP cooperation. Finally, although urban -rural differences are mentioned, the in-depth analysis of low-cost and easy to promote service models in underdeveloped areas such as rural areas is still insufficient, failing to fully address the issue of fairness in the development of the elderly care service system. In the future, research in this field needs to seek breakthroughs in the following areas. The first priority is to strengthen interdisciplinary integration, combining gerontology, psychology, information science, etc., adopting a "people-oriented" design thinking, and jointly developing truly age appropriate technologies and services. Secondly, we should deepen micro empirical and long -term tracking research, use rigorous methods to evaluate the long -term effects of policy interventions, and explore in dept h the adoption decision-making process of the elderly. Finally, it is necessary to focus on differentiated paths, strengthen refined research on specific elderly groups such as rural and remote areas, as well as disabled and low-income groups, explore feasible models that meet their real needs, and promote the elderly care service system to move towards a new stage of fairness, efficiency, and warmth. 2.3. Research Design and Methods This study adopts a combination of qualitative and quantitative research methods to ensure the scientific and in - depth nature of the research. (1) Literature research method: Systematically collect and analyze policies, regulations, statistical yearbooks, academic papers, and research reports on elderly care services at the national and Anhui provincial levels, to grasp the macro background and policy environment. (2) Case analysis method: Select representative home - based elderly care service institutions in Anhui Province for in-depth case studies. Through semi-structured interviews, participatory observation, and other methods, gain a deep understanding of their operating models, service content, difficulties faced, and successful experiences. (3) Policy text analysis: Conduct content analysis on local policy documents such as the "14th Five Year Plan for the Development of Elderly Care Services in Anhui Province" and the "Regulations on Home based Elderly Care Services in Hefei City", and sort out the key points, highlights, and possible blind spots of government support policies. (4) Data analysis method: Using publicly available data released by the Anhui Provincial Bureau of Statistics and the Department of Civil Affairs, descriptive statistical analysis is conducted on indicators such as the structure of the elderly population, the number of service institutions, and the size of beds, presenting an objective development status. 3. Current Situation Analysis The effectiveness and challenges of the construction of the home-based elderly care service system in Anhui Province are first reflected in the structural characteristics of its service target - the elderly population, which constitutes the starting point for all analysis. (1) Structure of elderly population: Large base and obvious aging trend: As of the end of 2022, among the 61.27 million permanent residents in the province, the elderly population aged 60 and above reached 12.16 million, accounting for 19.85% of the total population, and the degree of aging has 92 exceeded the national average level. Among them, the population aged 65 and above is 9.88 million, accounting for 16.15%, indicating that over 80% of the elderly population belongs to the middle-aged and elderly group. In addition, the proportion of pure elderly households continues to rise, with some areas exceeding 40% of the total elderly population, posing a rigid demand for specialized and normalized home - based elderly care services. (2) Service institutions and bed size: The total number has begun to take shape, but the per capita level is relatively low. Statistics show that there are about 3200 various types of home-based elderly care service institutions in the province, of which community elderly care service stations account for more than 70%. The total number of elderly care beds is about 420000, including about 280000 home -based elderly care beds. According to the population aged 60 and above, there are approximately 34.5 elderly care beds per thousand elderly people. Although it is close to the target of the 13th Five Year Plan, it is still lower than the national average level. From a regional distribution perspective, the number of beds in central cities such as Hefei and Wuhu accounts for 35% of the total in the province, while the coverage density of service facilities in rural areas of northern Anhui is significantly insufficient. (3) Service supply structure: basic services are the main focus, and the integration of medical care and elderly care needs to be deepened The current services provided by service institutions mainly focus on daily care and cultural entertainment, accounting for about 75%; However, the supply of professional services such as medical care, rehabilitation guidance, and psychological comfort is insufficient, accounting for less than 20%. In terms of the integration of medical care and elderly care, only about 15% of home -based elderly care institutions have established stable contract service relationships with community health service centers. The coverage rate of remote health monitoring equipment is less than 30%, which is difficult to meet the medical and nursing needs of elderly people who are elderly, disabled or semi disabled. 4. Existing Issues Based on the above development status, it can be found that Anhui Province's home-based elderly care service institutions are facing several deep-seated contradictions and challenges behind their rapid development, among which the problem of service supply and demand being disconnected is particularly prominent. (1) At the service supply level, there is a serious homogenization of service content, which is significantly disconnected from the diversified and refined needs of the elderly At present, the service items provided by most home-based elderly care service institutions in Anhui Province are highly similar, and they are generally concentrated in basic life care fields such as helping meals and cleaning, presenting a low- level competition of "more Congee than monks". However, with the increasing aging and empty nest trend of the elderly population structure, their real needs have deeply extended to professional fields such as medical care, rehabilitation guidance, psychological comfo rt, emergency rescue, and aging adaptation. This structural contradiction of "supply not demand" leads to idle basic service resources on the one hand, and unmet high-level and personalized needs on the other hand, resulting in low service efficiency. (2) At the human resources level, there is a severe shortage of professional nursing staff, poor team stability, and an urgent need to improve the level of specialization Human resources are the core bottleneck restricting the high-quality development of home-based elderly care services in Anhui Province. The prominent problem is manifested as "three lows and one high": firstly, low career attractiveness. The high intensity of nursing work and low social recognition result in a lack of competitiveness in salary levels, making it difficult to attract professional talents. Secondly, the level of specialization is low. The proportion of certified nursing staff is less than 50%, and most of the practitioners come from rural left behind women or "4050" personnel. They have only received short -term training and lack professional knowledge in medical nursing, psychology, and other fields, making it difficult to meet the complex needs of elderly care. The third issue is the low stability of the team. Due to unclear career development paths and incomplete security systems, the annual turnover rate of employees is over 25%, and service continuity cannot be guaranteed. 'One high' refers to high management costs. Institutions need to continuously invest a large amount of resources in repetitive recruitment and basic training, further squeezing their already limited operating profits. (3) Sustainable development aspect: weak profitability, excessive reliance on government subsidies, and inadequate market-oriented "hematopoietic" mechanisms Anhui Province's home-based elderly care service institutions are generally facing severe financial sustainability challenges. Its income structure heavily relies on government purchasing service projects and construction and operation subsidies, often accounting for over 60%, while the proportion of operating income generated through market - oriented services is extremely low. This model has obvious drawbacks: firstly, its ability to resist risks is weak. Once government subsidy policies are adjusted or fun ding disbursement is delayed, institutions will face a survival crisis. The second is the distortion of market mechanisms. Overreliance on "blood transfusion" leads to a lack of motivation for institutions to actively explore market demand, innovate service projects, and improve service quality. The third issue is the imperfect pricing mechanism. For inclusive services, prices are strictly limited and it is difficult to cover the true costs; However, for high-end personalized services, due to the lack of brand and professional support, the pricing ability is insufficient, resulting in the difficulty of improving their market-oriented and self generating functions. 5. Suggestions for Countermeasures To address the aforementioned issues and promote high - quality development of home-based elderly care service institutions in Anhui Province, a systematic response strategy must be adopted. The first step is to completely transform the service mindset from "supply oriented" to "demand oriented". (1) Adhere to demand-oriented approach and promote the transformation of precision services Establish a unified comprehensive evaluation system for the abilities and needs of the elderly throughout the province, develop scientifically quantified evaluation standards, and form a digital demand portrait of "one person, one file". Promote the "menu based" service and "project-based" supply model, dividing services into basic guarantee and personalized selection projects. The government guarantees 93 basic needs through issuing service vouchers and other means, while encouraging elderly people to purchase personalized services at their own expense according to their needs. Focus on special disadvantaged groups such as disabled, semi disabled, elderly, and living alone, implement a "household responsibility system" for regular on -site services, and ensure that rigid needs are effectively met. (2) Strengthen the construction of talent team and innovate the development mode of operation Build a full chain talent mechanism of "attracting, nurturing, and retaining", cooperate with universities and vocational colleges in the province to carry out "order based" training, and establish graded training bases. Improve the salary system based on skill levels and service quality, implement the system of entry subsidies and job allowances, and facilitate career development channels. At the same time, we actively explore innovative models such as "smart elderly care", "property + elderly care", and "time banking", support institutions to develop inclusive and high -end service products, enhance market-oriented "hematopoietic" capabilities through differentiated operations, and reduce excessive dependence on government subsidies. (3) Establish a sound and diverse collaborative mechanism to optimize the industry's development ecosystem Clarify the role of the government in "ensuring basic needs, establishing mechanisms, and strengthening supervision", focus on ensuring basic services for elderly people in need, and establish and improve industry standards and quality supervision systems. Fully implement preferential policies for land, taxes, and fees, encourage social forces to become the main providers of services, and promote the "public construction private" operation model. By implementing measures such as training in child care skill s and implementing a nursing leave system, we aim to strengthen the foundation of home-based elderly care, establish a collaborative governance pattern of "government led, social participation, and family responsibility", and comprehensively improve the qu ality, efficiency, and sustainability of home-based elderly care services 6. Conclusion This study takes Anhui Province as an example to systematically analyze the current development status and core issues of home-based elderly care service institutions. Anhui Province has initially formed a home-based elderly care service network covering urban and rural areas, but still faces challenges in terms of service accuracy, talent professionalism, operational sustain ability, and diversified collaboration. At present, there is a significant contradiction between the homogenization of institutional service content and the diversified needs of the elderly. The shortage of professional nursing talents and insufficient market-oriented capabilities restrict the improvement of service quality, while the collaborative mechanism between government, market, community and other entities is not yet perfect. To achieve this, comprehensive measures must be taken from four dimensions: demand-oriented, talent construction, model innovation, and diversified collaboration, to promote the transformation and upgrading of home-based elderly care service institutions from "quantity" to "quality", and to consolidate their fundamental position in the elderly care service system. Looking towards the future, the development prospects of home-based elderly care services in Anhui Province are broad. With the deepening of the 14th Five Year Plan for the elderly care service system, the deep integration of digital technology and elderly care services, and the gradual transformation of the entire society's elderly care concept, home-based elderly care service institutions will usher in new opportunities for professional, market-oriented, and intelligent development. Next, we should continue to improve the precise service mechanism centered on demand assessment, build an integrated talent system of "attracting, nurturing, and retaining", expand innovative models such as "smart elderly care" and "property + elderly care", and further optimize the ecological pattern of government, society, and family collaborative governance. Through multiple measures, Anhui Province is expected to form a replicable and promotable high-quality development path for home-based elderly care services, which not only provides solid support for the elderly in the province to achieve "original home security", but also provides valuable practical references for similar regions across the country. Acknowledgments This work is supported by the key school level scientific research project of Anhui University of Finance and Economics "Research on the Performance Evaluation Indicator System and Its Optimization for Home -based Elderly Care Service Institutions -- Taking Anhui Province as an Example" (Grant No: XSKY25042ZD). References [1] Liu Hao, Li Fulian, Wang Sheng. Research on the Coupling and Coordination Pattern and Influencing Factors of Home Community Elderly Care and Institutional Elderly Care in China [J/OL]. Geography of Arid Regions, 1-19 [2021-10-31]. [2] Liu Xinxin, Liu Xiaoyun. Research on the Digital Transformation Path of Community Home based Elderly Care Services [J/OL]. Theoretical Exploration, 1-8 [25-10-31]. [3] Dong Yan, Liu Shijie. Public data authorization operatio n response to the dilemma of smart home-based elderly care [J]. Journal of Sichuan Normal University (Social Sciences Edition), 2025, 52 (05): 94-103+203. 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