Table 1_Digital inclusion in China’s national smart health and older adult care policy design: an access-oriented and uneven embedding pattern, 2013–2025.xlsx

Among all coded statements, 48.8% contained no explicit digital inclusion orientation, 42.2% addressed access and environment, and only 9.0% addressed capability-building and safety protections. Policy instruments were significantly associated with digital inclusion orientations. Technology/data and platform interconnection instruments were over-represented in access- and environment-oriented inclusion, while capability-building and safety-protection measures were mainly concentrated in fiscal and regulatory instruments.

Older adults’ needs were also unevenly aligned with digital inclusion. Health care and service access needs dominated the policy corpus, whereas social–emotional support, development and autonomy, and participation-oriented needs received limited attention. Overall, digital inclusion was framed mainly as infrastructure, platform development, and service accessibility rather than a broader capability, affordability, safety, and participation challenge.</p>Conclusion<p>This study identifies an access-oriented and uneven embedding pattern of digital inclusion across policy instruments and need domains in China’s national smart health and older adult care policy design.

Moving towards equity-sensitive digital ageing policy requires greater attention to capability-building, affordability support, safety protection, offline fallback arrangements, and participation-oriented support. The Policy Alignment Framework offers a transferable tool for assessing digital inclusion governance in ageing and digitally transforming societies. As this study examines national policy design rather than implementation outcomes, the findings indicate policy intent and textual orientation, not actual digital inclusion effects.</p>