Abstract：
Community-based psychological counselling services (CPCS) is crucial for the oldest-old who often faces challenges or are reluctant to seek care at the healthcare settings. This study aims to examine trends in availability of CPCS over time and rural-urban disparities in service availability among nationwide oldest-old in China.
Multiple cross-sectional data were derived from the 2005-2018 Chinese Longitudinal Health Longevity Survey. Service availability was reported by each oldest-old participant or their next-of-kins as having CPCS in one\'s neighborhood. We used Cochran-Armitage tests to estimate service availability trends and applied sample-weighted logistic regression models to examine its rural-urban disparities.
Of 38,032 oldest-old, CPCS availability decreased from 6.7 % in 2005 to 4.8 % in 2008/2009, followed by continual increases to 13.6 % in 2017/2018. In 2017/2018, rural oldest-old\'s neighborhoods had no greater service availability. Oldest-old residing in the Central (6.7 %), Western (13.4 %) and Northeast China (8.1 %) were less likely to report having services locally than their Eastern counterparts (17.8 %). Oldest-old having any disability or living in the nursing homes reported having greater service availability than those without disability or living at home.
Service availability might have been disrupted during the COVID-19 pandemic.
Despite the increasing service availability, as of 2017/2018, only 13.6 % oldest-old in China had reported CPCS availability. It raises concerns on the disproportionate access to and continuity of mental health care, especially for those living the Central, Western China and those living at home. Policy efforts are needed to incentivize service expansion and eliminate disparities in the service availability.
Multiple cross-sectional data were derived from the 2005-2018 Chinese Longitudinal Health Longevity Survey. Service availability was reported by each oldest-old participant or their next-of-kins as having CPCS in one\'s neighborhood. We used Cochran-Armitage tests to estimate service availability trends and applied sample-weighted logistic regression models to examine its rural-urban disparities.
Of 38,032 oldest-old, CPCS availability decreased from 6.7 % in 2005 to 4.8 % in 2008/2009, followed by continual increases to 13.6 % in 2017/2018. In 2017/2018, rural oldest-old\'s neighborhoods had no greater service availability. Oldest-old residing in the Central (6.7 %), Western (13.4 %) and Northeast China (8.1 %) were less likely to report having services locally than their Eastern counterparts (17.8 %). Oldest-old having any disability or living in the nursing homes reported having greater service availability than those without disability or living at home.
Service availability might have been disrupted during the COVID-19 pandemic.
Despite the increasing service availability, as of 2017/2018, only 13.6 % oldest-old in China had reported CPCS availability. It raises concerns on the disproportionate access to and continuity of mental health care, especially for those living the Central, Western China and those living at home. Policy efforts are needed to incentivize service expansion and eliminate disparities in the service availability.
摘要：
背景：基于社区的心理咨询服务（CPCS）对于经常面临挑战或不愿在医疗机构寻求护理的年龄最大的老年人至关重要。这项研究旨在研究中国全国最古老的老年人的CPCS可用性随时间的趋势以及城乡服务可用性的差距。
方法：多个横断面数据来自2005-2018年中国纵向健康长寿调查。服务可用性由每个最老的参与者或他们的近亲报告为在一个邻居中具有CPCS。我们使用Cochran-Armitage检验来估计服务可用性趋势，并应用样本加权逻辑回归模型来检查其城乡差距。
结果：在38,032个最古老的人中，CPCS的可用性从2005年的6.7%下降到2008/2009年的4.8%，随后在2017/2018年继续增加到13.6%。在2017/2018年，农村最古老的社区没有更大的服务可用性。居住在中环最古老的老人(6.7%),西部（13.4%）和中国东北（8.1%）报告在当地提供服务的可能性低于东部（17.8%）。有任何残疾或住在疗养院的最年长的人报告说，他们比没有残疾或住在家里的人有更大的服务可用性。
结论：在COVID-19大流行期间，服务的可用性可能已经中断。
结论：尽管服务可用性不断提高，截至2017/2018年,中国仅有13.6%的年龄最大的老年人报告有CPCS.它引起了人们对精神保健的过度获取和连续性的关注，特别是对于那些住在中央的人来说，中国西部和那些住在家里的人。需要做出政策努力来激励服务扩展并消除服务可用性方面的差异。
方法：多个横断面数据来自2005-2018年中国纵向健康长寿调查。服务可用性由每个最老的参与者或他们的近亲报告为在一个邻居中具有CPCS。我们使用Cochran-Armitage检验来估计服务可用性趋势，并应用样本加权逻辑回归模型来检查其城乡差距。
结果：在38,032个最古老的人中，CPCS的可用性从2005年的6.7%下降到2008/2009年的4.8%，随后在2017/2018年继续增加到13.6%。在2017/2018年，农村最古老的社区没有更大的服务可用性。居住在中环最古老的老人(6.7%),西部（13.4%）和中国东北（8.1%）报告在当地提供服务的可能性低于东部（17.8%）。有任何残疾或住在疗养院的最年长的人报告说，他们比没有残疾或住在家里的人有更大的服务可用性。
结论：在COVID-19大流行期间，服务的可用性可能已经中断。
结论：尽管服务可用性不断提高，截至2017/2018年,中国仅有13.6%的年龄最大的老年人报告有CPCS.它引起了人们对精神保健的过度获取和连续性的关注，特别是对于那些住在中央的人来说，中国西部和那些住在家里的人。需要做出政策努力来激励服务扩展并消除服务可用性方面的差异。
