Supply-demand structural analysis of sports services in Chinese residential care facilities: a cross-sectional study in Zhengzhou.

Background: Sports services constitute an important non-medical intervention for promoting healthy aging. China has the world's largest older population with growing demand for institutional care; however, systematic research on supply-demand matching of sports services in residential care facilities remains scarce. Methods: This cross-sectional study surveyed 278 older adults across 15 residential care facilities in Zhengzhou, China, between March and June 2025. Based on the SERVQUAL gap model, supply-demand status was assessed across five dimensions: facilities, fitness guidance, activity organization, information consultation, and physical monitoring. The dependent variable was constructed using a project counting method: the supply side was measured by service accessibility (SA1-SA5, binary items assessing "whether the institution provides the service"), and the demand side by the number of dimensions with urgent needs (demand mean > 4.0); a difference ≤ 0 was coded as supply deficit. Binary logistic regression was employed with overall satisfaction ( Results: A pronounced structural imbalance in supply and demand was identified. Facilities (gap = 1.03, shortage rate 25.6%) and fitness guidance (gap = 1.02, shortage rate 25.2%) exhibited the strongest demand yet poorest supply, whereas activity organization was relatively well-supplied but ranked lower in demand priority. Significant demographic differences existed across institution types: residents of public institutions had significantly lower self-care ability than those in private institutions ( Conclusion: Sports services in residential care facilities exhibited a structural contradiction characterized by the coexistence of "high demand-low supply" and "low demand-high supply." Satisfaction, education level, and monthly income were identified as three key predictors of supply-demand imbalance: older adults with higher satisfaction (i.e., better perceived service quality) had lower odds of supply deficit, while those with higher education and income were associated with less supply-demand mismatch, potentially owing to superior information access and resource utilization capabilities. The non-significant effect of institution type, combined with demographic comparisons, suggested a compositional effect-public institutions bore greater responsibility for functionally impaired and economically vulnerable older adults, yet this structural difference in resident composition was not associated with significant differences in sports service supply-demand matching. However, given the cross-sectional design, these associations should not be interpreted as causal relationships.