Care Services In China Research Articles

Factors influencing demand and acceptance of hospice care among Chinese older adults: A meta-analysis

ABSTRACT This study aimed to systematically integrate existing research findings on relevant factors influencing Chinese older adults to choose hospice care, thus providing targeted theoretical support and a basis for the promotion of hospice care services in China. The literature on factors affecting the older adults’ choice of hospice care services were retrieved from nine databases, including PubMed, Embase, Web of Science, The Cochrane Library, CNKI, Wanfang Data, VIP, CBM, and SinoMed. The data were extracted and analyzed using Revman5.3 and Stata17.0. A total of 11 articles are incorporated, and 13 related factors are extracted. The meta-analysis results show that the demand and acceptance of hospice care services in the older adults are related to age (RR = 1.39, 95% CI (1.17,1.65), p = 0.0002), education level (RR = 1.94, 95% CI (1.42,2.63), p < 0.001), marital status (RR = 1.21, 95% CI (1.05,1.40), P = 0.007), death attitude (RR = 1.21, 95% CI (1.53,9.45), p = 0.004), having experienced or witnessed emergency treatment (RR = 2.07, 95% CI (1.51,2.85), p < 0.001), and living condition (RR = 1.32, 95% CI (1.00,1.73), P = 0.05). The elders who are at an advanced age, well educated, unmarried in solitude, and have experienced or witnessed emergency treatment have a high demand and acceptance of hospice care services

Recommendations for Expanding the Clinical Role of Audiologists in Hospitals in Mainland China: Insights From a Survey-Based Study

Purpose: This study aims to collect information on the current duties and educational backgrounds of clinical audiologists in mainland Chinese hospitals, aiming to making recommendations for the scope of practice for them. Method: A survey-based study focused on clinical audiologists in mainland China was conducted. This survey sought to collect comprehensive information regarding their educational backgrounds, work duties, and responsibilities. After reaching out to a potential pool of 495 participants within an online community of clinical audiologists, 162 responses were received from various hospitals across mainland China. Results: The survey findings indicate that most clinical audiologists in China are primarily engaged in hearing/auditory-related assessments. Although most respondents have received proper clinical audiology training, with 98.77% holding a bachelor's degree or higher, their role closely resembles that of audiology technicians, with many lacking the authority to explain test results to patients (60.49%) or to choose specific assessments (75.93%). Despite their substantial training in audiology, the scope of their clinical responsibilities is notably limited. Conclusions: Given the extensive audiological training that these professionals undergo and the growing demand for audiology and hearing care services in China, there is a compelling justification for expanding the duties of clinical audiologists in Chinese hospitals. Such an expansion could encompass audiological consultations and a more direct role in patient care, thereby improving the quality and accessibility of audiology services in China.

Influence of service quality and customer perceived value on customer loyalty with customer satisfaction as a moderating factor: A study based on private elderly care services in China

Amidst China’s escalating aging population challenge, the efficacy and quality of private elderly care services are garnering increasing scrutiny. This research focuses on evaluating how service quality and customer perceived value influence the loyalty of elderly clients, with customer satisfaction acting as a mediating factor. Grounded in established service quality frameworks and loyalty theories, the study utilizes a quantitative methodology, administering surveys across eight private elderly care institutions in H city, China. A total of 600 surveys were collected, providing a comprehensive data set that encompasses five dimensions of service quality—tangibility, assurance, responsiveness, reliability, and empathy—as well as customer perceived value, satisfaction, and loyalty. Structural Equation Modeling (SEM) was employed to validate the hypothesized relationships. Findings reveal that service quality significantly boosts customer perceived value and satisfaction, which in turn markedly enhance customer loyalty. Notably, customer satisfaction emerged as a crucial mediator between service quality and loyalty, as well as between perceived value and loyalty. This study not only advances theoretical understanding of service quality impacts but also offers actionable insights for enhancing service delivery and customer loyalty in the context of private elderly care.

Study on the Participation of Social Enterprises in Community Home-based Elderly Care Services

With the further aggravation of the aging problem in China, different types of senior care services are showing a trend of integration and development, and the model of community-based home care services is being widely adopted in China, and social enterprises can become one of the important main bodies involved in the provision of community-based home care services due to their advantages in specialization and personalization. However, the current development of social enterprises in China still has certain problems in obtaining legal status, enhancing credibility and improving operational efficiency. Therefore, it is necessary to solve the development dilemma of social enterprises in the intervention of community-based elderly care services by increasing government support, improving the level of business operation and strengthening publicity and promotion, so as to enhance the blood-forming ability of the enterprises themselves and further optimize the market of elderly care services in China.

Introduction: Elderly Care Services in China: Exploring an Integrated Approach towards Active Ageing

Introduction: Elderly Care Services in China: Exploring an Integrated Approach towards Active Ageing

Study on the measurement of coupling and coordinated development level between China’s internet and elderly care services and its influencing factors

BackgroundWith the intensification of China’s aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services.MethodsIn this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services.Results(1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of “disorder recession-transition coordination-coordinated development”. (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services.ConclusionIn order to promote the coordinated development of China’s Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China’s Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China’s Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China.

Association Between Community Elderly Care Services and the Physical and Emotional Burden of Family Caregivers of Older Adults: Evidence from Beijing, China.

The rate of usage of community elderly care services in China is low, and past studies about the effects of these services on caregiver burden domestically are few. This study used a large sample of Beijing census data (n = 55,634) to examine the impact of these services on caregiver burden. Logistic regression and propensity score matching were used to estimate the effects. The results showed that meal assistance, respite care, and spiritual comfort are all significantly associated with a lower likelihood of perceived emotional burden among caregivers, while only respite care is very significantly associated with a lower likelihood of feeling physically burdened. However, the effects of these services on caregiver burden also depend on the activities of daily living performance and location of residence of the care recipients. The practical implications for policy makers are discussed.

Application of Failure Mode and Effects Analysis to Improve the Quality of the Front Page of Electronic Medical Records in China: Cross-Sectional Data Mapping Analysis.

The completeness and accuracy of the front pages of electronic medical records (EMRs) are crucial for evaluating hospital performance and for health insurance payments to inpatients. However, the quality of the first page of EMRs in China's medical system is not satisfactory, which can be partly attributed to deficiencies in the EMR system. Failure mode and effects analysis (FMEA) is a proactive risk management tool that can be used to investigate the potential failure modes in an EMR system and analyze the possible consequences. The purpose of this study was to preemptively identify the potential failures of the EMR system in China and their causes and effects in order to prevent such failures from recurring. Further, we aimed to implement corresponding improvements to minimize system failure modes. From January 1, 2020, to May 31, 2022, 10 experts, including clinicians, engineers, administrators, and medical record coders, in Zhejiang People's Hospital conducted FMEA to improve the quality of the front page of the EMR. The completeness and accuracy of the front page and the risk priority numbers were compared before and after the implementation of specific improvement measures. We identified 2 main processes and 6 subprocesses for improving the EMR system. We found that there were 13 potential failure modes, including data messaging errors, data completion errors, incomplete quality control, and coding errors. A questionnaire survey administered to random physicians and coders showed 7 major causes for these failure modes. Therefore, we established quality control rules for medical records and embedded them in the system. We also integrated the medical insurance system and the front page of the EMR on the same interface and established a set of intelligent front pages in the EMR management system. Further, we revamped the quality management systems such as communicating with physicians regularly and conducting special training seminars. The overall accuracy and integrity rate of the front page (P<.001) of the EMR increased significantly after implementation of the improvement measures, while the risk priority number decreased. In this study, we were able to identify the potential failure modes in the front page of the EMR system by using the FMEA method and implement corresponding improvement measures in order to minimize recurring errors in the health care services in China.

SOCIAL STRUCTURAL DISPARITIES IN DENTAL CARE UTILIZATION AMONG ADULTS IN CHINA’S MEGACITIES

Abstract This study utilized data from the “2019 New Era and Living Conditions in Megacities Survey” to investigate social structural disparities in dental care utilization among adults aged 18-65 from 10 megacities in China. Logistic regressions were conducted to examine the relationships between social structural factors, such as hukou status, occupational status, migrant status, and city of residence, and dental care utilization. Margins post estimation was used to explore whether the social structural disparities in dental care utilization were associated with changes in oral health status. Results showed that only 22.36% of participants had at least one dental visit per year. Having urban hukou as compared with rural hukou (OR, 1.76; 95% CI, 1.47-2.12), working in state-owned enterprise as compared with in other enterprises (OR, 1.34; 95% CI, 1.14-1.57), and living in more developed cities as compared with in less developed cities (OR, 1.48; 95% CI, 1.27-1.72) were associated with a higher likelihood of regular dental visits. Additionally, participants with urban hukou and those living in more developed cities were more likely to have regular dental visits when their oral health was good, such as when they had full natural teeth. This study highlights social structural disparities in oral health behaviors among adults in China’s megacities. The findings suggest that efforts should be made to improve dental care utilization by promoting public messaging about oral health knowledge, expanding dental care coverage, and improving access to dental care services in China.

An evolutionary game-based simulation study of a multi-agent governance system for smart senior care services in China

BackgroundThe competing interests of the government, smart senior care technology service providers, and older adults have led to a serious fragmentation of governance in China. This study aims to identify the collaboration mechanisms and evolutionary stabilization strategies for these agents.MethodsAn evolutionary game model is developed to analyze the strategic decisions made by the government, smart senior care technology service providers, and older adults. A sensitivity analysis is conducted using data from Anhui Province, China, to verify the effects of relevant parameters on the strategy decisions of each agent.ResultsThe results of the simulation and sensitivity analysis indicated that, first, despite changes in the initial willingness values of the tripartite agents, the system eventually converges on 1. Second, the collaboration mechanism of the tripartite agents in the smart senior care system is related to government incentives, penalties, and subsidies, smart senior care service costs, and the additional benefits provided to smart senior care technology service providers.ConclusionThe strategy decisions of the government, providers, and older adults interact with each other. To promote collaboration among the tripartite agents and improve governance effectiveness, the government should strengthen the regulations for providers, increase penalties for providers that engage in a breach of trust, provide moderate incentives and subsidies, and control smart senior care service costs.

Telehealth use and work stress among Chinese health care providers during the COVID-19 pandemic

Telehealth services in China rapidly expanded during the COVID-19 pandemic. The work stress of health care providers (HCPs) associated with providing telehealth care services in China has been less studied. Our study describes the telehealth services provided by hospitals in China and examines the relationships between telehealth use and work stress of HCPs in China during the COVID-19 pandemic. With a survey research design, HCPs aged 18 or older in China were electronically recruited from October 19 to November 10, 2021 (n=1,073). After preprocessing, data from 1,036 HCPs were used for further analyses, which included descriptive statistics and multiple linear regression models. Results showed that 64.29% of Chinese hospitals reported virtual physician-to-physician consultations, and 59.94% of Chinese HCPs conducted online physician consultations. Lower levels of HCP work stress was associated with live video conferencing (p=0.04), online physician consultations (p=0.00), and higher levels of team collaboration (p=0.00) and team trust (p=0.00). Work stress was also positively correlated with COVID-19 stress (p=0.00), working hours (p=0.00), and the interaction between live video conferencing and COVID-19 stress (p=0.04). HCPs’ work stress decreased by using live video conferencing and online patient care. However, the positive effects of live video conferencing may decrease with the increase in COVID-19 stress for HCPs. Our findings encourage efforts to develop extensive coverage of telehealth service systems in China to promote HCPs’ virtual communication and collaboration to relieve HCPs’ work stress and support their well-being.

Caregivers of ALS Patients: Their Experiences and Needs

We explored the care experiences and needs of the home caregivers of patients with amyotrophic lateral sclerosis (ALS) to improve their quality of life. We interviewed home caregivers in-depth and analyzed the data using Colaizzi's descriptive phenomenological method. We interviewed 11 home caregivers of patients with ALS with a disease duration between 1.5 and 4 years. Primary caregivers were predominantly female and were the patients' spouses. Daily caregiving time averaged 4–14 h for 0.5–3.5 years. Interview themes included helplessness and adaptation to life changes, hopelessness, compassion for the patient’s prognosis, and expectation for diverse support. The study sample size was limited, as all participants were from a single tertiary hospital, and all patients had severe functional impairment. Caregivers of patients with ALS experience a considerable burden. Patients and their caregivers can benefit from diversified support channels, and assistive communication systems can be applied to home care. Future research will focus on in-home public long-term care services in China.

Characteristics and Admission Preferences of Pediatric Emergency Patients and Their Waiting Time Prediction Using Electronic Medical Record Data: Retrospective Comparative Analysis.

The growing number of patients visiting pediatric emergency departments could have a detrimental impact on the care provided to children who are triaged as needing urgent attention. Therefore, it has become essential to continuously monitor and analyze the admissions and waiting times of pediatric emergency patients. Despite the significant challenge posed by the shortage of pediatric medical resources in China's health care system, there have been few large-scale studies conducted to analyze visits to the pediatric emergency room. This study seeks to examine the characteristics and admission patterns of patients in the pediatric emergency department using electronic medical record (EMR) data. Additionally, it aims to develop and assess machine learning models for predicting waiting times for pediatric emergency department visits. This retrospective analysis involved patients who were admitted to the emergency department of Children's Hospital Capital Institute of Pediatrics from January 1, 2021, to December 31, 2021. Clinical data from these admissions were extracted from the electronic medical records, encompassing various variables of interest such as patient demographics, clinical diagnoses, and time stamps of clinical visits. These indicators were collected and compared. Furthermore, we developed and evaluated several computational models for predicting waiting times. In total, 183,024 eligible admissions from 127,368 pediatric patients were included. During the 12-month study period, pediatric emergency department visits were most frequent among children aged less than 5 years, accounting for 71.26% (130,423/183,024) of the total visits. Additionally, there was a higher proportion of male patients (104,147/183,024, 56.90%) compared with female patients (78,877/183,024, 43.10%). Fever (50,715/183,024, 27.71%), respiratory infection (43,269/183,024, 23.64%), celialgia (9560/183,024, 5.22%), and emesis (6898/183,024, 3.77%) were the leading causes of pediatric emergency room visits. The average daily number of admissions was 501.44, and 18.76% (34,339/183,204) of pediatric emergency department visits resulted in discharge without a prescription or further tests. The median waiting time from registration to seeing a doctor was 27.53 minutes. Prolonged waiting times were observed from April to July, coinciding with an increased number of arrivals, primarily for respiratory diseases. In terms of waiting time prediction, machine learning models, specifically random forest, LightGBM, and XGBoost, outperformed regression methods. On average, these models reduced the root-mean-square error by approximately 17.73% (8.951/50.481) and increased the R2 by approximately 29.33% (0.154/0.525). The SHAP method analysis highlighted that the features "wait.green" and "department" had the most significant influence on waiting times. This study offers a contemporary exploration of pediatric emergency room visits, revealing significant variations in admission rates across different periods and uncovering certain admission patterns. The machine learning models, particularly ensemble methods, delivered more dependable waiting time predictions. Patient volume awaiting consultation or treatment and the triage status emerged as crucial factors contributing to prolonged waiting times. Therefore, strategies such as patient diversion to alleviate congestion in emergency departments and optimizing triage systems to reduce average waiting times remain effective approaches to enhance the quality of pediatric health care services in China.

Home/Community-Based Medical and Elderly Care Services Utilization in China: A Cross-Sectional Study from the Middle-Aged and Elderly Population.

Few studies have analyzed the acceptance of home/community-based medical and elderly care services in China. Therefore, we conducted a cross-sectional study to describe the acceptance of five services among people aged ≥ 45 years in the China mainland, and their influencing factors. The data were obtained from the database China Health and Retirement Longitudinal Study 2018. For each service, a binary logistics regression was adopted. A total of 9719 people were included, of whom 20.12% received services. The numbers of recipients (acceptance rates) of the five services, namely, comprehensive aged care services, regular physical examinations, onsite visits, health management, and entertainment, were 107 (1.10%), 1640 (16.87%), 323 (3.32%), 156 (1.61%), and 245 (2.52%), respectively. About 4% of people had received two or more services. The elderly aged 65-74 and those who were satisfied with the local medical services had higher acceptance of services. Urban hukou having health insurance, two or more chronic diseases, provincial economic welfare, and social welfare were positively associated with the acceptance of regular physical examination services. It is suggested that the government should gradually improve satisfaction with local medical services, and pay more attention to the needs of elderly people aged 65-74 for all kinds of home/community-based medical and elderly care services.

Exploring a competency framework for the chief financial officer of a hospital: a qualitative study from China

BackgroundHospital chief financial officer (CFO) plays a vital role in supporting the effective management of organization. Understanding their competencies is essential to improve hospital development and health care services in China. This paper aims to explore competencies necessary for hospital CFOs to fulfil their management responsibilities and develop a competency framework for hospital CFOs in China.MethodsA qualitative study was applied by conducting in-depth interviews with 151 participants from 15 Chinese provinces, comprising 89 individuals from 67 hospitals, and 62 individuals from 39 medical universities. Interviews were anonymised, recorded and transcribed. Qualitative thematic analysis was applied through a multi-stage review process and modified via the Delphi process using a national panel of 36 experts.ResultsUsing content analysis, we identified 17 competencies organized into three themes (personal attitudes, leadership competencies and managerial competencies) to conduct a competency framework for hospital CFO to fulfil their management practices. Those competencies emphasized the integration of different competencies required by the hospital CFO.ConclusionsThis paper identified the detailed expertise, abilities and personal traits required by hospital CFOs in China, expanding the insights and perspectives of hospital CFOs currently working in China to literature. The proposed framework will help hospitals establish selection criteria, coaching tools, and development plans for CFOs.

Factors influencing the satisfaction of community senior care services in China: an analysis based on an extended Anderson model.

Community-based senior care, as a convenient and promising care model, has gradually been accepted by the public. However, community services developed to facilitate older adults often fail to achieve the expected effect. With the fast-growing aging population in China, the problems of underutilization and low service satisfaction of senior care facilities need to be resolved urgently. In this study, we further developed an extended Anderson behavior model by incorporating social psychological factors, and the vertical and horizontal fairness perceptions. In addition, a binary logistic regression model was used to analyze factors affecting the satisfaction of older adults in life care services, health care services, and mental and spiritual comfort services. The study used data from a survey of 322 urban area seniors in Shaanxi Province. The results showed that factors influencing older adults' satisfaction of different service categories are different. Moreover, with the addition of the social psychological factors, we observed that the vertical fairness perception of the survey respondents affected their satisfaction of senior care services significantly more than the horizontal fairness perception.

Projections of Future Demand and Costs of Aged Care Services in China

Projections of Future Demand and Costs of Aged Care Services in China

Estimating the efficiency of primary health care services and its determinants: evidence from provincial panel data in China.

The efficiency of primary health care services is drawing increased attention worldwide, especially in developing countries. Health care reform in China has moved into the 'deep water zone' phase and is facing the dilemma of inefficiency in primary health care services, which is a critical challenge for universal health coverage. In this study, we estimate the efficiency of primary health care services in China and its determinants. A combination of a super-SBM (Slack-Based Measure) model, a Malmquist productivity index model and a Tobit model is used to study provincial panel data, and the results demonstrate the inefficiency of primary health care services in China and the variations in efficiency values between regions. Over time, the productivity of primary health care services shows a decreasing trend, mainly due to slowing technology change. Financial support is needed to improve the efficiency of primary health care services, but it is worth noting that existing social health insurance coverage decreases efficiency, while economic development, urbanization and education also have a significant impact. The findings suggest that increasing financial support should remain a priority in developing countries but that reasonable reimbursement design, appropriate payment methods and comprehensive supporting social health insurance policies are key to the next step of reform.

A Study of Factors Influencing the Demand for Infant and Toddler Childcare Services in Wuhan Based on Regression Analysis

Faced with the surge in demand for childcare services brought about by social and economic development, it is urgent to improve the infant and toddler childcare service system. However, there are large differences between domestic and foreign related studies, and domestic studies mostly stay at the macro level or qualitative description of the problem, lacking in-depth analysis of specific demand factors. This study uses literature analysis, questionnaire survey, interview, textual analysis and quantitative analysis to explore the current situation, influencing factors and development countermeasures of the demand for infant and toddler care services in Wuhan from a micro perspective, aiming to enrich the theoretical results of the demand for infant and toddler care services in China.

Reflection on the development status and dilemma of rural elderly care services

In recent years, with the intensification of population aging, population aging has become a major obstacle to China's economic and social development, which has also caused a series of pension problems. Although in recent years China has introduced a series of positive measures to cope with the aging of the population, and has been committed to solving the problem of rural pension, the problem of pension has been alleviated to a certain extent, but compared with the town, the development of rural pension services in China is relatively late, the problem of pension is still prominent, only the establishment of an effective pension service system in rural areas can help solve this problem. In order to promote the better development of rural areas, the state proposed the implementation of the rural revitalization strategy, and the proposal of the 2018 rural revitalization plan pushed the new round of rural pension plan to a new stage, thus providing some strategic opportunities for the construction of rural elderly care service system. This paper will analyze the development status of rural elderly care services in China, combine the rural revitalization strategy, explain the opportunities and challenges brought by the rural revitalization strategy to China's rural elderly care services, and explore the way to further improve China's rural elderly care service system.