Taking pension institutions in Henan Province as the research object, the nearest neighbor index method, kernel density estimation method and the optimal parameters-based geographical detector were used to analyze the spatial distribution characteristics and its factors of pension service institutions at the city and county scale. The results showed that: (1) There were various types of institutions in Henan Province and the cost was low, the coverage of nursing homes was sufficient. The distribution of beds in Zhengzhou and Luoyang was the most sufficient, and there were differences in the proportion of institutions nature between types. (2) The overall pension institutions showed a cohesive distribution, among which the nursing homes were close to the random mode and the distribution was relatively balanced, while other types of institutions were agglomerated. (3) The elderly care homes and apartments for the elderly showed significant characteristics of dense north and sparse south, and small regional aggregation, there were differences in pension resources between municipal districts and counties, and there was a strong trend to set up in urban built-up areas. The number of elderly care centers and community nursing homes was small, showing no significant distribution characteristics. The coupling between the institution nature and the built-up area was significantly different, and the degree of private institution coupling was high. (4) Environmental greening, urbanization level and economic level were the main influencing factors of the spatial distribution of pension service institutions, the influence of population factor was low, and the interaction between urbanization rate and GDP was strong.
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