Long-term care system for older adults in China: policy landscape, challenges, and future prospects

Feng, Zhanlian; Glinskaya, Elena; Chen, Hongtu; Gong, Shuai; Qiu, Yue; Xu, Jianming; Yip, Winnie

doi:10.1016/s0140-6736(20)32136-x

Cited by 318 publications

(309 citation statements)

References 38 publications

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“…It was presented that only about half of the beds in the elderly care institutions in Chengdu urban area were applied, and 32.5% of the urban institutions in Tianjin, Harbin, Jinan, Wuhan and other cities are in de cit for a whole year, with an overall low bed occupancy rate [56]. The number of social workers also needs to be improved by 22%, which is consistent with the current situation that China's integrated medical and nursing system is still far from perfect, the corresponding number of nursing staff is still small, and also the professional level is very low [57]. Social workers, as the mainstay resources to ensure the service quality, their competence can be applied to comprehensively evaluate nursing homes.…”

Section: Comparison Of Te Of Nursing Homes In Eastern Central and Western Regions In Chinamentioning

confidence: 83%

Service Efficiency of Nursing Homes Based on DEA and Tobit Model: a Longitudinal Study in China

Zhang

Han

Fang

2021

Preprint

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Background: Low utilization of care resources in China continues to be a challenging problem even though the rapid development of pension services. However, few studies have explored the utilization of care services with either the production of nursing homes at a national and longitudinal level. Methods: The present study analyzes the spatio-temporal distribution of TE and productivity of nursing homes by using the data from China Civil Affairs statistical yearbook (2012-2016). Analysis was conducted based on the Data Envelopment Analysis and Tobit model, which have been widely applied to integrate several quality measures as a comprehensive benchmark. Results: The average TE, PTE and SE of nursing homes were 0.909. 0.928 and 0.979 from 2012 to 2016, respectively. The TE and SE decreased from 2012 to 2014, but improved after 2014. TE is 0.98 in the Eastern region, 0.93 of that in the Central region and 0.91 of that in the Western region, with a decrease range of 2%, 7% and 9%, respectively. The average improvement range of the five input indexes of the non-DEA effective nursing homes was 27.26%, 20.62%, 19.77%, 22.04%, and 38.84%, respectively. The influencing factors of efficiency value of nursing homes indicated that if there are more social workers, more patients in the nursing homes, and more employees who are aged 56 and above, the TE and productivity of nursing homes will be higher.Conclusion: We find that TE of nursing homes in Western regions are all at the lowest, as the current facilities can neither provide equitable nor optimal access and utilization. The decline of the efficiency and productivity before the healthcare reform implementation in 2014 was significant, where the influencing factors could be age and gender of employees, the number of social workers, and older people. Finally, suggestions are put forward for improving the efficiency of allocation and utilization of care services.

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Section: Comparison Of Te Of Nursing Homes In Eastern Central and Western Regions In Chinamentioning

confidence: 83%

Service Efficiency of Nursing Homes Based on DEA and Tobit Model: a Longitudinal Study in China

Zhang

Han

Fang

2021

Preprint

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“…Various technologies (including robotics and telehealth) have been widely used to substitute, supplement, or simply support human caregivers in the delivery of elderly care in many countries, such as Japan, the USA, and some European countries. 33 , 34 The expanding aging population and limited elderly care indicate that China has a long way to go to deal with the aging society effectively.…”

Section: Discussionmentioning

confidence: 99%

<p>Current Status and Challenges of Community-Based Elderly Care Centers in Chongqing, China: A Cross-Sectional Study</p>

Yang

Jiang

Wang

et al. 2020

RMHP

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Purpose China is facing various societal pressures owing to its rapidly aging population. In order to provide evidence-based suggestions to promote elderly care, this study investigated the community-based elderly care centres (CBECCs) in Chongqing of China, focusing on the site selections, physical environment, facilities, and operation. Methods All CBECCs in a district of Chongqing were analysed via a single-stage cluster sampling survey design. Descriptive statistics were used to analyse the data. Results A total of 69 CBECCs (60 government-run and 9 collective-run centres) were identified and analysed. Most site selections were reasonable. CBECCs that were located inside of apartment complexes with entrance guards, not located on main roads, and near a market were more popular. Only 4 (13.3%) CBECCs that were not located on the ground floor were equipped with elevators. A small number of CBECCs were near a noise pollution (10.1%) or far from a medical institution (11.6%). Nearly half (42.7%) of CBECCs only had an indoor area of <200 m2. Nearly all CBECCs had sufficient ventilation, natural lighting, and sufficient floor-to-floor height. 51.5% and 88.4% of the CBECCs fully met the criteria of ‘four rooms and one canteen’ and ‘eight functional zones’, but no significant difference was found in terms of the number of people served per month between the CBECCs that met the criteria and those that did not. A quarter of the CBECCs were operated by part-time staff. Only half provided home services (54.5%). The median of average number of people they served every month was 100 (interquartile range = 10–300). Conclusion Certain problems existed in the current CBECCs. Better elderly care especially calls for adequate elevator establishment, sufficient indoor and outdoor space, appropriate facilities and service, qualified managers and caregivers. A feasible and evidence-based plan to optimize the physical environment and facilities, functional layout and service provision is crucial to improve the CBECC service.

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“…One of the main reasons for this is the Chinese cultural value of 'filial piety' wherein family care has been the major source of care for the elderly in China for thousands of years (Zeng et al., 2019). More than 95% of the long‐term care of older Chinese people is either self‐care or provided by their families, especially for those outside the welfare system (Feng et al., 2020). Furthermore, as a result of rapid demographic and socioeconomic shifts, such as changes in family structures, increases in empty nests, increases in life expectancy and decreases in available family caregivers, the current model of care for the elderly in China is not capable of delivering care to all of the elderly in need (Zeng et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Multidimensional factors affecting care needs in daily living among community‐dwelling older adults: A structural equation modelling approach

Zhang

Chen

et al. 2021

J Nurs Manag

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Aims To develop a model illustrating the factors that can influence care needs in daily living (CNDL) of older adults and the pathways between these. Background The care needs in community‐dwelling older adults have increased sharply. A better understanding of the elderly's CNDL would thus help policymakers define which types of support and services should be given. Methods A multicentre study with structural equation modelling was conducted in this study. We recruited 3,448 community‐dwelling older adults in China by using a stratified random cluster sampling technique. Results Physical and mental health was the strongest predictor of CNDL. Both age and living situation had positive effects on CNDL, while economic factors, social support and family support were the major risk factors for CNDL. Conclusion The presented model provides a better understanding of how to address CNDL in the targeted population. The older adults who are the oldest, low‐income, non‐empty nesters, and with poor self‐rated health or the signs of loneliness should be firstly targeted for daily assistance. Implications for Nursing Management Using this model could provide health authorities and managers with the information of distinguishing between the priority group and the strategies for easing the caregiving burden in older adults care, and thus improving resource utilization.

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Long-term care system for older adults in China: policy landscape, challenges, and future prospects

Cited by 318 publications

References 38 publications

Service Efficiency of Nursing Homes Based on DEA and Tobit Model: a Longitudinal Study in China

Service Efficiency of Nursing Homes Based on DEA and Tobit Model: a Longitudinal Study in China

<p>Current Status and Challenges of Community-Based Elderly Care Centers in Chongqing, China: A Cross-Sectional Study</p>

Multidimensional factors affecting care needs in daily living among community‐dwelling older adults: A structural equation modelling approach

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