Evaluation and Spatio-Temporal Evolution of the Suitability of Elderly Care and Wellness: A Case Study of the Zhejiang Demonstration Zone for Common Prosperity

Introduction The aging population in Zhejiang Province—China’s Demonstration Zone for Common Prosperity—exceeds the national average, and regional development is uneven. This study aims to assess the level and spatio-temporal evolution characteristics of the Suitability of Elderly Care and Wellness (SECW) in Zhejiang Province, providing a basis for optimizing policies and achieving a balanced allocation of regional wellness resources. Methods A comprehensive evaluation index system encompassing three dimensions—natural resources, social resources, and social support—was constructed. The entropy weight method was employed to determine indicator weights, and comprehensive scores for the SECW across 11 prefecture-level cities in Zhejiang Province from 2014 to 2023 were calculated. Moran’s I indices were used to analyze the spatial correlation patterns. Results The overall SECW in Zhejiang Province showed an upward trend, but regional disparities persisted. A “three-tier” spatial pattern emerged: Hangzhou and Ningbo serve as high-value core centers driven by strong resource agglomeration; coastal and central cities form a dynamically competing middle tier; and southwestern areas remain as the relatively lagging third tier. Spatial analysis revealed an overall negative spatial autocorrelation tendency across the province, dominated by “High-Low” and “Low-High” association patterns, with no significant high-value agglomeration areas. Conclusion The wellness resources in Zhejiang Province exhibit a “center-periphery” structure, with insufficient regional synergistic development. It is recommended to bridge the medical insurance gap, prioritize healthcare ‘software’ over physical facilities in lagging cities, and establish cross-city care and wellness consortia between core highlands and adjacent depressions.