Objective  To examine the demand for elderly care and its associates among older rural residents and to provide evidences for improving elderly care services in China.

  Methods  Using stratified multistage random sampling, we recruited 600 residents aged ≥ 60 years at 20 villages in 5 provinces across China and conducted a survey among the elderly with a self-designed questionnaire on the status and related factors of elderly care needs from January to March 2019.

  Results  Totally 560 (43.2% male and 56.8% female) residents completed the survey. For all the respondents, the average score for overall care was 6.01 ± 1.83 out of the full mark of 17; the average domain score for emotional care was higher than that for daily life care (2.79 ± 0.88 vs. 1.67 ± 1.83) and the score (1.56 ± 0.74) for medical care was the lowest among the domain scores. The top three emotional care needs reported by the respondents were harmonious neighborhood relationship, children′s company and community activity and the top three daily life care needs were caregiver′s service, financial support and children′s care. For medical care, the respondents paid more attentions to improving medical conditions and reducing medical expenses. Based on the results of multivariate linear regression analysis, main impact factors were education, self-care ability, whether with children living nearby, and whether having regular physical examination for care needs of the rural elderly.

  Conclusion  The elderly in rural China need more emotional care and daily life care, especially those with lower education, without self-care ability, without children′s care, and having no regular physical examination.