Care Services In China Research Articles

Participation of social organizations in embedded elderly care services in urban communities from the perspective of cooperative governance: interactions, dilemmas and strategies --Taking the SX Health Care Center in City C as an example

Community-embedded elderly care effectively integrates the advantages of institutional, family and community-based elderly care in practice and greatly integrates multiple social resources, which is a trend for the future development of elderly care services in China in the context of an aging population. Cooperative governance provides new analytical ideas for community-embedded elderly care services, and the community-embedded elderly care model in City C has just emerged and is in the exploration stage. Taking SX Health Care Center, currently the first community-embedded elderly care pilot in city C, as an example, this paper finds, after investigation and research, that there are cooperation dilemmas in the practice of social organizations participating in urban community-embedded elderly care services, such as insufficient supervision of government responsibility, competitive market environment, limited development capacity of actors and lack of trust on the demand side. In the future, it is necessary to coordinate and integrate all parties through "leading the cooperation order, optimizing the cooperation relationship, improving the cooperation supervision and enhancing the cooperation capacity", with a view to optimizing the local urban community embedded elderly care model and building a good long-term cooperative elderly care service mechanism.

A cross-sectional survey on information access through hospital's official account on new media and its association with antenatal care knowledge and health behaviors of pregnant women under COVID-19 epidemic

Objective To explore the association between accessing antenatal care information through hospitals' official new media accounts and antenatal care knowledge and individual prevention behavior under COVID-19 epidemic, and to provide evidence for improving the emergency plan for maternity health care services in China under public health emergencies. Methods The online survey was conducted from Feb 5th to Mar 1st, 2020, at the peak of the COVID-19 epidemic in China. Approaches of accessing antenatal care information, COVID-19 related antenatal care knowledge and individual prevention behavior was collected via cross-sectional design. Results A total of 1 936 valid questionnaires were obtained from 21 provinces, autonomous regions and municipalities. Under the COVID-19 epidemic, 75.4% of the pregnant women reported they got institutional service and health education information from hospitals' official new media accounts such as WeChat and Weibo. Multivariate Logistic analysis showed that pregnant women who received information from official accounts of new media had higher scores of COVID-19 relevant antenatal care knowledge (aOR=1.36, 95%CI:1.08-1.71, P<0.01)and individual prevention behaviors(aOR=1.46, 95%CI:1.18-1.82, P<0.01) than those who obtained information from other sources. Conclusion The access to antenatal care knowledge via hospitals' official social media accounts was associated with better antenatal care knowledge and individual prevention behaviors among pregnant women. Under major public health emergency, it is suggested for health institutions to disseminate antenatal health care information via hospitals' official accounts in new media like Wechat and Weibo. Appropriate training should be developed to ensure the quality of health education and service provision in official new media accounts. © 2021, Editorial Department of Fudan University Journal of Medical Sciences. All right reserved.

The Grandmothers’ Farewell to Childcare Provision under China’s Two-Child Policy: Evidence from Guangzhou Middle-Class Families

As China’s one-child policy is replaced by the two-child policy, young Chinese women and their spouses are increasingly concerned about who will take care of the ‘second child.’ Due to the absence of public childcare services and the rising cost of privatised care services in China, childcare provision mainly relies on families, such that working women’s choices of childbirth, childcare and employment are heavily constrained. To deal with structural barriers, young urban mothers mobilise grandmothers as joint caregivers. Based on interviews with Guangzhou middle-class families, this study examines the impact of childcare policy reform since 1978 on childbirth and childcare choices of women. It illustrates the longstanding contributions and struggles of women, particularly grandmothers, engaged in childcare. It also shows that intergenerational parenting involves a set of practices of intergenerational intimacy embedded in material conditions, practical acts of care, moral values and power dynamics. We argue that the liberation, to some extent, of young Chinese mothers from childcare is at the expense of considerable unpaid care work from grandmothers rather than being driven by increased public care services and improved gender equality in domestic labour. Given the significant stress and seriously constrained choices in later life that childcare imposes, grandmothers now become reluctant to help rear a second grandchild. This situation calls for changes in family policies to increase the supply of affordable and good-quality childcare services, enhance job security in the labour market, provide supportive services to grandmothers and, most importantly, prioritise the wellbeing of women and families over national goals.

A quality function deployment–based resource allocation approach for elderly care service: Perspective of government procurement of public service

In response to the rapidly growing demand for elderly care service in China, rational allocation of limited resources and improvement of public satisfaction have become one of the urgent problems to be solved in government procurement of elderly care services. With the aid of quality function deployment, a programming model is established to allocate resource with maximizing customer satisfaction. Taking home care service as an example, on the basis of identifying the elderly’s requirements, designing attributes, optimal allocation of limited resource is conducted based on the proposed approach. Results show that staff in the home care service center should pay more attention to improve their service attitude and service quality. Meanwhile, more resources should also be allocated to improve the specialization of the franchise center, and to increase the provision of professional medical personnel and purchase of common medicines for emergencies as well as facilities for rehabilitation. This study expands the field of elderly care service by introducing a more efficient resource-allocation approach, thus helping governments in decision-making.

Community-based elderly care services in China: an analysis based on the 2018 wave of the CLHLS Survey

Community-based elderly care services play an important role in dealing with population aging. Based data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, we found that overall there was high demand for community-based elderly care services, but insufficient supply, resulting in unmet needs. The greatest demand was for medical care and nursing services and these were generally more accessible compared to other services. The imbalance between available supply and elderly demand was greatest for personal care and psychological consulting services. Additionally, there were obvious imbalances of supply and demand for particular groups of the elderly population. In terms of demand, the young-old living in eastern and western China or urban areas had stronger demand for community-based elderly care services. Elderly people with serious disabilities or low income, or living in rural areas and towns had more demand for home visit medical services, while the elderly with the ability to care for themselves or high incomes needed more social and entertainment services. With respect to inadequate supply, the demands for community-based elderly care services of the low-income elderly living in rural areas and towns or in western China were more likely to be unmet. Our results indicated that appropriate services should be provided by government agencies and institutions to meet the needs of various groups. It is also important to increase accessibility to community-based elderly care services as well as to guarantee an equitable distribution of supply.

A Study to Evaluate the Efficacy of Different Interventions for Improving Quality of Maternal Health Care Service in China.

Abstract Background/Introduction: The quality of maternal health care service is a crucial determinant of maternal morbidities and mortalities. This study aimed to explore feasibility and relative efficacy of WeChat (WC), of specialist team (ST) service, and of combined of both interventions (WC-ST) for improving the quality of maternal health care in China. Materials and Methods: A four-arm randomized controlled trial of 1,400 pregnant women was conducted in three hospitals in Chengdu, Southwest China, from December 2016 to October 2017. Eligible women were randomly assigned to either of three intervention groups or the control group (service as usual; SAU). Main outcome measures were satisfaction rate and uptakes of maternal health care service at 49 days postpartum based on questionnaire survey. Results: No significant differences in satisfaction rate were found among four groups at baseline (p = 0.981), and significant group differences were noted at 49 days postpartum (p < 0.001), with the highest rate from WC-ST group (98.6%), followed by that of ST (95.2%) and WC (91.6%) groups, and SAU group being the lowest (85.2%). The same pattern of group difference was observed in measures of health care uptake behaviors. Most health care uptake measures from the baseline to post-trial were significantly improved within each of the intervention groups, while most such measures in the control group were not different from baseline to post-trial. Discussion and Conclusions: The WC and ST service is feasible and potentially effective in improving the quality of maternal health care service in China. The study has revealed limitations and options for improvement in future main trial.

An Empirical Study on the Demand Analysis of 0 - 3-Year-Old Infants’ Care Service in China &amp;lt;br/&amp;gt;—Based on a Survey in Province G

The study adopts the self-made questionnaire of 0 - 3-year-old children’s demand for child care, investigating 6564 families with 0 - 3-year-old children in G province by means of cluster probability sampling. The survey shows that most parents’ willingness to care is not strong, and the acceptable monthly cost of care is mainly within 2000 Yuan. The main reason for choosing care is to let children receive professional care and education. The main reasons for not choosing nursery are that families can take care of themselves; parents are most concerned about the safety of nursery institutions and the professionalism of the staff; they prefer to choose public nursery institutions. Therefore, we should actively construct a multi-level and multi-level care service system to better meet the demand of care services of 0 - 3-year-old infants.

The current situation and future prospects of elderly care services in China

The current situation and future prospects of elderly care services in China

Tensions in dementia care in China: An interpretative phenomenological study from Shandong province.

The study aims to analyse the tensions and the challenges of dementia care that are experienced by people with dementia and their family caregivers in China. China has the largest dementia population in the world; however, dementia care services and related support services are still developing. Caring for a person with dementia is very challenging, as evidenced by many studies. As the majority of people with dementia are looked after by their family in their homes in China, it is very important to understand what people with dementia and their family caregivers are experiencing in the context of dementia care services that are in the process of developing. Interpretative phenomenological analysis (IPA) was used. Semi-structured individual interviews with 24 participants (10 people with dementia and 14 unrelated family caregivers) recruited from a mental health centre in Shandong Province. Three main themes emerged that highlighted unmet need: (a) Lack of support services, (b) Insufficient institutional care and (c) Social attitude and social stigma towards dementia. These themes reveal the challenges that the participants face in the context of dementia care services that are in the process of development in China; and how their lived experiences have been affected by the constraints of social support, public services, healthcare access, long-term care services and social stigma. This study highlights the tensions that are identified by people with dementia and family caregivers. The research recommends that more support services would be beneficial for this group and would also enhance family support dementia care in China. Looking after an older family member is a culturally, socially and legally embodied norm in Chinese society, so it is important to address education for dementia awareness and the sustainability of family support care services in China by providing dementia services and resources to support both people with dementia and family caregivers.

INDIVIDUALIZED SPORTS MANAGEMENT SCHEME FOR PREGNANT WOMEN IN CHINA

In recent years, pregnant women in China generally face problems such as unbalanced and excessive nutrition, lack of proper exercise during pregnancy, which shows a significant increase in weight during pregnancy, leading to an increasing trend of perinatal complications. At present, there is less sports health management system for pregnant women throughout pregnancy. In view of this, based on the existing research in related fields, this study deeply explores the appropriate monitoring methods of pregnant women’s sports in China. In this study, effective and convenient testing methods and evaluation criteria were proposed for pregnant women’s sports and psychology. The research idea was a method based on the pulse wave to detect pregnant women’s cardiac reserve capacity, and grading the Diastolic/Systolic value of pregnant women as a reference for grading individualized target heart rate range of moderate intensity exercise. The effective time and energy expenditure of pregnant women were assessed by monitoring the exercise process. The purpose is to help and guide pregnant women in the whole process of pregnancy self-movement management, and thus improve the quality of maternal health care services in China.

A Structured Cognitive Intervention Pathway as a decision-support tool for non-pharmacological interventions within a dementia care service (Innovative practice).

Individual cognitive interventions for Alzheimer’s disease have been shown to be beneficial and cost effective when evaluated as sole interventions. However, there is a need for a systematic, person-centric, structured approach to guide non-pharmacological intervention selection based on disease stage, symptoms, outcome assessment, and individual requirements. Our Structured Cognitive Intervention Pathway aims to facilitate the selection of first-line, or subsequent, non-pharmacological management for people with Alzheimer’s disease living at home and in elderly care facilities. We discuss the Pathway’s conceptual basis and evaluation of implementation as a decision-support tool within a dementia care service in China.

Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese.

Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.

Long-term care services and care workers in Hangzhou City, China: A cross-sectional survey.

This study aims to investigate the organisation and the workforce profile in long-term care facilities in Hangzhou City, China. Population ageing calls for an increase in the number of high-quality, long-term care services. Therefore, there is a pressing need to understand how these services are organized and the qualifications of their workforce. A cross-sectional questionnaire survey was conducted among 293 care workers in 21 certified long-term care facilities in Hangzhou City, China. Comparison between government-owned and private facilities was conducted. In total, there were 8,898 beds, 5,468 residents and 887 care workers in the facilities surveyed. As the total bed occupancy rate was 61.5%, there appeared to be adequate facilities in the city. The ratio of care workers to residents was similar in both the government-owned and private facilities, 1 care worker to 6.16 residents. For dependent residents, this ratio was 1-3.50. Organisation of the care services in terms of shift pattern, in-job training and care worker's insurance was significantly different between the two types of facilities. Despite the government-owned facilities being better organized than the private ones, both types of aged care facilities had a 24-hr-long shift. Although their monthly wage was similar, care workers in the government-owned facilities received better job-related insurance, were younger, had longer years of aged care work experience, were better educated and held more aged care certificates and received more frequent in-job training than their counterparts in the private facilities. The shift arrangement needs to be improved. The low education level, long working hours and low remuneration of care workers were barriers for the development of the long-term care services. In order to improve the quality of long-term care services in China, the organisation of work, qualifications and payment of care workers need to be improved.

Ageing communities as co-designers of social innovation

ABSTRACTThis paper addresses the social phenomenon of ageing and emphasizes the importance of past experiences of ageing individuals when creating new solutions to deal with the issue of elderly care. Thus, this paper explores what role the ageing community can play in creating new service solutions for social innovation in senior care and also looks to ascertain how past experiences of the elderly can empower them to develop their own services. A comparative analysis is adopted as a method to respond to these aims. Two projects are used for this comparative analysis. Life 2.0 focused on generating information and communication technology services to provide a platform of support in social interaction for ageing people throughout the EU. BoAi focused on exploring the possibility of transferring the ‘good old days’ into current elderly care services in China.

The Smart Elderly Care Service in China in the Age of Big Data

China is just experiencing a period of population aging accelerating. With the approaching of an aging society, elderly care becomes increasingly challenging; however, a variety of disadvantages has been exposed gradually, including unsatisfactory health care, unstable daily care, insufficient emotional comfort, no timely emergency aids, and so forth. The traditional elderly care model has already impeded, to a large extent, the sustainable development of elderly care. As the rapid development and wide application of big data, smart elderly care comes into being, which shows various advantages while comparing with traditional elderly care services. The Chinese government has the responsibility to implement the smart elderly service in its initial stage of development.

When more is less: What explains the overuse of health care services in China?

Overuse of health care services has become an increasingly severe problem in China. However, as both academic interests and practical efforts have mainly focused on reducing underuse, our understanding of overuse is far from complete. This study aims to analyze the status of overuse of health care services in China and explore both the supply- and demand-side factors associated with overuse. We took common cold, a self-limiting viral infection which requires no injections or infusions, as a tracer condition. Based on data from the fourth and fifth Health Service Survey of Shaanxi Province, we generated an observable indicator to measure overuse: whether or not a patient received infusion treatment for common cold during outpatient visits. The statistics showed that 58.73% and 37.56% of patients had infusion treatment for common cold during outpatient visits in 2008 and 2013, respectively. Based on this dependent variable, we employed Probit analysis to investigate factors influencing the overuse of health care services. The multivariate regression results showed that on the demand side, overuse was positively associated with low health literacy, long duration of illness, large family size, and high economic status. On the supply side, overuse was relatively high in hospitals at the county level and above as well as in cities with relatively low density of health care workforce. Our results also provided some evidence for the effectiveness of health care reform policies like the essential medicines programme in reducing overuse.

Pioneer of Chinese Ophthalmology--130th Anniversary of Beijing Tongren Hospital.

Much has been achieved in clinical and scientific research in the past 130 years by Beijing Tongren Hospital, which has evolved from an eye clinic to a comprehensive hospital with an ophthalmology department known as one of the best in China. This article presents the most historic moments and events in the development of a hospital with the largest eye care service volume. In addition, given the leading position of Tongren, the development of ophthalmology in Tongren is also the epitome of the development of modern ophthalmology in China. Beijing Institute of Ophthalmology (BIO) was established in 1959 as an affiliated institution under Tongren, aiming at carrying out applied science and basic science research, and directors of BIO have thus far served 4 terms as president of the Chinese Ophthalmological Society. In 2002, Beijing Tongren Eye Center (hereafter referred to as the Eye Center) was established to combine all the ophthalmic resources within Tongren. In 2017, the Eye Center alone had a surgical volume of 78,223, with surgeries for cataract, refractive errors, fundus, glaucoma, and corneal disease being the 5 most common, and 902,409 outpatient visits. Equipped with the leading experts and equipment, Tongren is dedicated to the battle against major eye diseases by carrying out large population-based epidemiological surveys and basic science research on pathogenesis and effective treatments, thereby making contributions to the development of the science of ophthalmology along with the delivery of eye care services in China and beyond.

Status of Elderly Care Services and Community-based Elderly Care Services in China

China has become the first aspiring global power that grows old before it can grow rich. And the challenges in delivering elderly services for aging population need to be tackled urgently. Based on the analysis of the status of elderly care services in China, we put forward that community-based elderly care services is the most appropriate kind of services for addressing the needs of an aging population. Moreover, in view of the challenges in delivering such services, we proposed some suggestions, such as improving relevant laws, establishing long-term care insurance system, enhancing service quality, improving service facilities, all these would lead the community-based elderly services to be utilized all over the country.

Reconstruction of a clinician training system in China-A successful "5+3" model from Shanghai.

To promote medical educational reforms and improve the quality of health care services in China, Shanghai has embarked on a pilot reform programme to combine 3-year graduate education with standardized residency training, which is called the 5+3 model and consists of 5years of undergraduate studies plus 3years of graduate studies integrated with standardized residency training. In the current review, we present the reconstruction and practice of the model in China.

Quality of life in Chinese patients with schizophrenia treated in primary care

In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians. This study examined the quality of life (QOL) in patients with schizophrenia treated in primary care and explored the demographic and clinical characteristics associated with QOL. Altogether, 612 patients with schizophrenia treated in 22 randomly selected primary care services in China formed the study sample. QOL, psychotic and depressive symptoms, extra-pyramidal symptoms and insight were assessed using standardized instruments. Data analyses were conducted with the one sample t-test and multiple linear regression analyses. Compared with the normative data for the Chinese general population, significantly lower scores in physical and mental QOL domains were found in the patient group. Older age, being unemployed, major medical conditions, no smoking, more severe depressive and negative symptoms, more frequent insomnia, and suicidality were independently associated with poor physical QOL. Male gender, more severe depressive and anxiety symptoms, more frequent insomnia, and suicidality were independently associated with poor mental QOL. Patients with schizophrenia treated in primary care had lower level of QOL in comparison with general population. Effective measures need to be implemented to improve their QOL.