Care Services In China Research Articles

Smart Elderly Care Services in China: Challenges, Progress, and Policy Development

In 2017, the State Council of China published an action plan for the construction of a smart and healthy elderly care industry (2017–2020). The action plan designed and implemented by the State Council of China demonstrates the Central Government’s determination to informationalise and digitalise the Chinese society. Therefore, the market of smart home care services should expectedly mushroom in the coming decades, as the demand for smart home care increase. However, there are a range of barriers to achieving the massification of smart home care services, which will be discussed in the following sections. In addition to the shortage of family care and nursing services, elders being physically and psychologically vulnerable also engenders the Central Government to accelerate the provision of smart home care services to the Chinese elderly population. Here, smart home investment and delivery are necessary when building a sustainable elderly care system. The investment in smart home elderly care can lessen the long-term burden on China’s healthcare system as more elders would be able to self-manage their everyday life and minor physical and psychological problems. In this article, the author would critically analyses China’s implementation of smart home elderly care services, particularly on the benefits and challenges of technological advancement in elderly care and the advantages and problems of relevant policy development. The author also highlights how the informationalisation and digitalisation in elderly care and policy development enhance the convenience of the elderly populations’ everyday life when family care is limited or absent. Additionally, the author assesses what the gaps are in existing smart home elderly care technologies and policy development that need to be addressed by Chinese policymakers to further advance the safety and convenience of the elderly cohorts’ living.

Application Research on a "5G+AI" Smart Elderly Care Service Platform System

Facing the growing demand for elderly care services in China, this paper designs a "5G+AI" smart elderly care service platform integrating 5G, AI, IoT, intelligent sensors and other technologies to open up channels for various elderly care providers, promote smart collaboration among service interfaces, service data and service resources, and further realize all-round elderly care support for the elderly at the individual, family and social levels, It provides a new solution to the increasingly serious elderly care problem.

How to promote grass roots medical treatment under China's graded diagnosis and treatment policy? - From the perspective of customer value theory.

Based on the background of the implementation of graded diagnosis and treatment policy (GDT) in China, this paper studied the service optimization of primary medical institutions from the perspective of the primary medical treatment rate. First, the difference-in-difference (DID) empirical strategy is used to analyze the impact of the implementation of the GDT on the improvement of the primary medical attendance rate, and the parallel trend test and the placebo test were used to test the robustness to illustrate the necessity of policy implementation. Second, combined with customer value theory, this paper used a logistic regression model to study the impact of customer value perception on grassroots medical care. The implementation of the GDT can indeed improve the rate of primary care (p = 0.028), but the impact is relatively small (0.042). From the perspective of value perception hierarchy, emotional value perception (p < 0.05) is the key factor that affects the behavior of grassroots medical treatment at this stage. This paper fills the gaps in existing research, including empirical research on the grassroots medical treatment behavior of the masses under GDT and the impact of value perception on grassroots medical behavior. Furthermore, the recommendations are made for primary care institutions based on the results of the analysis, which promote the advancement of primary care services in China.

A STUDY ON THE DEVELOPMENT STRATEGY OF CHILD CARE INSTITUTION FOR CHILDREN AGED 0-3 - TAKING A NURSERY INSTITUTION IN SHANDONG PROVINCE AS AN EXAMPLE

As the two-child and three-child policies have been universally put into place, China has introduced a lot of policies and measures to optimize birth rate to promote the growth of the new population, Amid policy circumstance, care service for children aged 0-3 has emerged and developed vigorously. However, the number of non-governmental child care institutions is increasing rapidly, and some early education institutions and training institutions have set up child care institutions using existing customer groups, resulting in fierce market competition. In addition, the short development period of infant and child care services in China leads to unsatisfactory service quality and unbalanced supply of service, moreover, in some child care institutions, there are excess children in class, insufficient teachers, high mobility of nursery governess, uneven professional ability of teaching staff, and insufficient hardware facilities, etc. Under the background of the development of A daycare institution in Shandong Province, in this paper, how the institution should seize the development opportunity of this new industry was discussed, and its own development strategy was formulated to base on the fierce market competition and realize sustainable development.

Nationwide-free preconception care strategy: Experience from China.

Preconception care has emerged as a developing field in maternal and child healthcare worldwide. This care type provides couples of reproductive age with the opportunity for early detection and management of biomedical, behavioral, and social health problems. In 2010, the Chinese government launched a nationwide preconception care program as a welfare project. During the past decade, this project has received international attention, and experiences from the project have been published in the literature. In this review, we summarize the history, implementation, and evaluation of preconception care services in China, and its related maternal and children's health service initiatives, to thereby provide knowledge for policymakers and clinicians in other countries.

The impact of human resources for health on the health outcomes of Chinese people

Human resources for health (HRH) is a cornerstone in the medical system. This paper combined data envelopment analysis (DEA) with Tobit regression analysis to evaluate the efficiency of health care services in China over the years between 2007 and 2019. Efficiency was first estimated by using DEA with the choice of inputs and outputs being specific to health care services and residents’ health status. Malmquist index model was selected for estimating the changes in total factor productivity of provinces and exploring whether their performance had improved over the years. Tobit regression model was then employed in which the efficiency score obtained from the DEA computations used as the dependent variable, and HRH was chosen as the independent variables. The results showed that all kinds of health personnel had a significantly positive impact on the efficiency, and more importantly, pharmacists played a critical role in affecting both the provincial and national efficiency. Therefore, the health sector should pay more attention to optimizing allocation of HRH and focusing on professional training of clinical pharmacists.

Examining Relationships among Chinese Preschool Children's Meeting 24-Hour Movement Guidelines and Fundamental Movement Skills.

Background: Few studies have investigated associations between meeting 24-Hour Movement Guidelines and preschool children’s fundamental movement skills (FMS). This study aimed to investigate the associations between Chinese preschoolers meeting various combinations of the Guidelines and FMS, as well as examining gender differences across those outcomes. Methods: A total of 322 preschool children (181 boys and 141 girls) aged 3–6 years old were recruited from five early-childhood education and care services in China. Children’s 7-day physical activity (PA) was assessed using accelerometry, and screen time (ST) and sleep duration were reported by their parents. FMS were assessed by Test of Gross Motor Development 3. Descriptive statistics and gender differences in children’s meeting the Guidelines and FMS were calculated using t-tests for continuous variables and Chi-square tests for categorical variables. Results: Most preschoolers met the sleep and ST guidelines, but only 22.3% met the PA guidelines; 4% of preschoolers did not meet any of the recommendations, while 9.3% met all three recommendations. Boys reported significantly higher compliance with all combined recommendations. There were positive associations between meeting the PA guidelines and both locomotor (β = 0.49; p < 0.001) and object control skills (β = 0.21; p < 0.001). A significantly positive relationship was identified between meeting PA + sleep guidelines and locomotor skills (β = −0.16; p = 0.02). A significantly negative association was observed between preschoolers’ meeting sleep + ST guidelines and locomotor skills (β = 0.31; p = 0.001). Conclusion: Few preschoolers met all three movement behavior guidelines. The findings suggest that PA levels, especially MVPA, are important for the promotion of FMS. Meanwhile, the impacts of ST and sleep on motor development cannot be neglected.

Community-Dwelling Older Adults' Intended Use of Different Types of Long-Term Care in China and Its Associated Factors Based on the Andersen Behavioral Model.

In light of the increased demand for long-term care services in China, there is an ongoing discussion on what factors contribute to older adults’ intended use of long-term care services. This study empirically recruited 239 community-dwelling older adults aged ≥60 years in China and explored factors influencing their intended use of four types of long-term care (basic life care, basic medical care, rehabilitation care, and psychological care) based on the Andersen behavioral model (i.e., predisposing characteristics, enabling resources, and need factors). The results showed that older adults were most likely to use psychological care. Age (as the predisposing characteristic) was the significant predictor of the intended use of four types of care. Regarding the intended use of basic life care, the enabling resources of marital status, household composition, income, as well as need factors of preference for the care setting, were influential. Moreover, income and need factors of self-rated physical health status were only two variables associated with the intended use of basic medical care. Concerning the intended use of rehabilitation care, household composition, income, self-rated physical health status, and preference for the care setting were significant predictors. The intended use of psychological care was influenced by enabling resources of marital status, household composition, and need factors of self-rated physical health status, preference for the care setting, and preference for the caregiver. These results can promote the sensitivity of policymakers and caregivers to the community-dwelling older adults’ intended use of long-term care and contribute to the delivery of appropriate care services by public policy.

Current public perception of, and barriers to, palliative care in China: a mixed-methods study

Cancer is a major cause of death in China, accounting for 2·56 million deaths in the country in 2018 alone. Yet, on that year, only 28 600 patients (1·1%) at the end of life received palliative care. Existing studies in palliative care have mainly been done in medical environments. The aim of this study was to focus instead on the general public and to identify the public's perceptions of, and demand for, various palliative care services, as well as barriers to palliative care in China. A convergent mixed-methods design was used to facilitate an understanding of the Chinese public's knowledge of palliative care services and the demand for palliative care. An interdisciplinary team of scholars and practitioners worked collaboratively to develop a contextually and culturally relevant questionnaire for the public in China (named KNPCP-1) to explore these issues. Quantitative and qualitative evaluation phases in the development of KNPCP-1 ensured its high validity. We did cross-over comparison analyses of the findings from the quantitative survey (conducted using KNPCP-1). Stata version 17.2 and NVivo version 12.6.1 were used for data analysis. 6120 people completed the qualitative surveys, and 19 survey respondents and 20 medical staff were also interviewed. No significant difference in knowledge of palliative care and general need for various palliative care services was found between men and women. A greater demand for palliative care services was found among rural respondents than among their urban counterparts. Convergent analysis indicates that factors or mechanisms associated with the low availability of palliative care services include scarce knowledge about palliative care, a cultural taboo around death, factors related to patient-clinician conflict, and the pressure on adult children to fulfil their filial duty of care for elderly parents. Several factors contribute to the low availability of palliative care services in China despite recent governmental awareness campaigns. Innovative and culturally sensitive approaches are needed to promote palliative care services in relation to the factors synthesised from the analysis. Ministry of Education of China, Youth Project of Humanities and Social Sciences (project number 20XJC840001); China Postdoctoral Science Foundation (project number 2021M691521); and 2020 Young Teacher Development Project of the Chinese Universities Scientific Fund (project number 230600001002020030).

A qualitative study exploring nursing students' perspectives on and attitudes towards hospice care in China

BackgroundWith the fast growth of the older population and the increasing rates of chronic illnesses, the demand for hospice care is increasing at a rapid pace. This is bringing great challenges to the healthcare system in China. Given that nursing students will be the main healthcare workforce in the future, and as such, have responsibilities to prepare for these challenges. Therefore, understanding nursing students' perspectives and attitudes towards hospice care in China is important to promote the development of hospice care services. ObjectivesTo explore the perspectives and attitudes of Chinese nursing students towards hospice care. MethodThe descriptive phenomenology of a qualitative approach was used for the study. Data were collected through semi-structured individual interviews from 11 nursing students in China between April and June 2021. Data were analysed using Colaizzi's seven-step approach. FindingsThree main themes were identified: (1) Lack of knowledge and skills; (2) lack of clinical experience; and (3) needs for service improvement. These findings indicated the problems of hospice care education and hospice care services in China. ConclusionThe nursing students in this study lacked theoretical knowledge and the practical skills of hospice care. This suggests that medical educational institutions and the government should take action to increase hospice care training for nursing students, in order to increase the capacity and availability of hospice care services. It also informs policy-makers, health professionals, and health educators about the further need for the development of hospice care services in China.

Analysis of Coupling Coordination Degree between Big Health Industry and Pension Service

With the aging of the population, the problem of providing for the aged has been paid more and more attention. The big health industry and old-age care services will complement and promote each other in terms of industrial factors, industrial layout, and policy linkage and form a coupling effect in this process. Hospital services and pension services are professional property service formats, and they are also the exploration achievements of the property management industry in implementing the supply-side structural reform, transformation, upgrading, and development and are indispensable forces for the property management industry to participate in building a better life. The health and happiness of the elderly is an important symbol of social civilization and progress, and it is also an important content of implementing the Healthy China Action. The pension industry serving the healthy life of the aged population will form a huge demand for the big health industry, and its development will drive the big health industry. Based on the background of the big health system, this paper analyzes the current situation and crux of the development of aged care services in China and puts forward ways to improve the quality of aged care services by optimizing the effective supply of aged care services, improving the environment of aged care services, and strengthening the precise supervision of aged care services.

Optimal Subsidy Support for the Provision of Elderly Care Services in China Based on the Evolutionary Game Analysis.

Public–private partnership is a type of cooperation that has been widely employed to alleviate contradictions between supply and demand in the elderly care industry in China. Based on evolutionary game theory, this paper mainly analyzes the effects of static subsidy and dynamic subsidy to private sectors and consumers on the evolution of the decision process for private investors, consumers, and government in the three-dimension system. The simulation results show that without active supervision, a higher subsidy to private sectors will not promote the provision of high-quality services when the cost saving is large. Furthermore, there exists a threshold value of the difference between the two types of subsidies such that elderly people will be encouraged to choose institutional care if the value exceeds the threshold. We also find that dynamic subsidy policy works more efficiently in promoting the provision of home-based care services.

Research on the Construction Strategies of Community-Based Targeted Elderly Care Service—Based on the Investigation of Elderly Care Services in Y City

Improving the precision of supply and demand of elderly care services is an important countermeasure to deal with the mismatch contradiction between supply and demand of elderly care services in China. Based on the investigation of the mismatch situation between supply and demand of elderly care services in Y City, from the perspective of social work, and according to the analysis framework of identifying-allocating-integrating, it is a practical path to improve the precision of supply and demand of elderly care services by constructing a community-based targeted elderly care service mode under the hub role of social work stations located in towns and streets. It is found that, there are three basic elements for the construction of the community-based targeted elderly care service mode: the life circles of the elderly in the community are the basis for the targeted identification of elderly care needs; the sense of belonging to the community organization where the elderly live is the basis of targeted allocation of elderly care resources; social work stations located in towns and streets with dual attributes of “state and society” are the basis for targeted integration of supply and demand process of elderly care.

New Pension Institution under the Background of Moderately Aging Population: Exploring the Model of Community Nursing Home

China's elderly population has been growing rapidly and will enter a moderately aging society in the 14th Five-Year Plan period. The demand for senior care industry will continue to increase in the moderately aging society, but the supply of senior care services in China is obviously insufficient, so we will develop the community nursing home model and create a more suitable service model for senior care by closely focusing on the aging population and senior care. This paper points out the value of community nursing home construction, analyzes the advantages and problems of two traditional aging models: home care and institutional care, and proposes a plan for community nursing home model: optimize the spatial layout of community nursing home, standardize community medical service institutions, adopt "government-enterprise cooperation" operation method, promote the industrialization of community nursing home, and improve the service system of community nursing home.

Research on the Evaluation of Elderly Care Service Supply Capability from the Perspective of Welfare Pluralism

Based on the welfare pluralism analysis paradigm, an elderly care service supply capability evaluation system with five dimensions, including family, government, market, society and collaboration is constructed. The entropy weight method is used to determine the weight, and the weighted sum method is used to calculate the comprehensive score. The differences in the supply capability of different subjects in 30 provinces (cities) in China in 2018 are analyzed. The study found that there is regional imbalance in the comprehensive supply capacity of elderly care services in China, and the eastern region is higher than the central and western regions: Beijing, Guangdong, Shanghai, Jiangsu, Shandong and other eastern regions have strong supply capability, while Shanxi, Yunnan, Heilongjiang, Xinjiang and Jilin and other central and western regions have weak supply capability. In addition, the supply of elderly care service also presents the different characteristics. Therefore, the paper puts forward some countermeasures and suggestions, such as establishing a balanced development strategy, narrowing the regional gap of elderly care service supply capability, enhancing the supply capability of various subjects, and accelerating the formation of a multi-subject responsibility sharing system for elderly care service.

Consultation Pricing of the Online Health Care Service in China: Hierarchical Linear Regression Approach.

BackgroundOnline health care services are a possible solution to alleviate the lack of medical resources in rural areas, and further understanding of the related medical service pricing system would contribute to improvement of the online health care community (OHC). Although many studies have investigated the OHC, the impact of physicians’ reputations and wage levels on consulting prices in the OHC has rarely been discussed in the literature.ObjectiveThis study was designed to explore the determinants of consulting prices in the OHC. We addressed the following questions: (1) Are the prices of online health consultation services affected by wage levels at the doctor’s location? (2) How does a physician’s online and offline reputation affect their consulting prices?MethodsEmploying a large-scale sample of 16,008 doctors in China, we first used descriptive statistics to investigate the determinants of consulting prices in their entirety. Hierarchical linear modeling was then used to investigate the determinants of consulting prices in the OHC.ResultsThe empirical results led to the conclusion that if doctors have more elevated clinic titles, work in higher-level hospitals, have better online reputations, and/or have made more past sales, their consulting prices will be higher. Additionally, the wage level in the city in which the doctor is working determines their opportunity cost and therefore also affects consulting prices.ConclusionsThe findings indicate that the characteristics of the doctor, the doctor’s online reputation, and past sales affect the consulting price. In particular, the wage level in the city affects the price of the consultation. These findings highlight that the OHC is important because it can indeed break through geographical restrictions and give rural residents the opportunity to obtain medical service from doctors in big cities. However, doctors from cities often charge higher fees because of their higher opportunity cost. The results reveal that one of the most important functions of the OHC is to reduce the medical disparity between urban and rural areas; however, planners appear to ignore the possibility that rural residents with lower incomes may not be able to afford such high medical consultation costs. Therefore, the government should consider providing incentives to encourage urban doctors to provide discounts to rural residents or directly offer appropriate subsidies.

Research on Urban and Rural Involvement in Smart Elderly Services

This article aims to overcome the challenges faced by traditional elderly care services in China and discuss the development opportunities of smart elderly care services in urban and rural areas. Additionally, seek feasible countermeasures based on the basic ideas of smart elderly care to promote the transformation of urban and rural elderly care services to smart and intelligent. Therefore, we can bridge the gap between urban and rural areas, break the urban-rural dual structure, and encourage cities and villages to share the benefits of reform and development.

Mental health and preventive behaviour of pregnant women in China during the early phase of the COVID-19 period

BackgroundThe COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China.MethodsA cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health.ResultsThe prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety (OR = 0.42–0.67) and higher frequency of washing hands (OR = 1.57–3.40). Higher level of education level was associated with probable depression (OR = 1.31–1.45) and higher frequency of wearing face mask (OR = 1.50–1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (aOR = 1.10–1.11), being quarantined (aOR = 1.42–1.57), personally knowing someone being infected with COVID-19 (aOR = 1.80–1.92), perception that COVID-19 would pose long term physical harm to human (aOR = 1.25–1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (aOR = 0.59–0.63) and lower tendency of always wearing face mask (aOR = 0.85). Social support was associated with lower levels of depression and anxiety (aOR = 0.86–0,87) and higher frequency of washing hands (aOR = 1.06).ConclusionsThe mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.

A Summary of Researches on the Quality of Home-based Care Services in China

With the increase of the aging of the population in china, the demand of the elderly continues to increase, which has brought great challenges to the elderly care service industry. As a new type of elderly care service, home-based care services directly affect the quality of the elderly&amp;rsquo;s health and daily life in their later years. Therefore, improving the product and quality of elderly care services has become the goal and purpose of the development of home-based care service for aged. This article uses Cite Space software to perform visual analysis of keyword clustering on existing literature, and concludes that scholars focus on the integration of medical care, social elderly care service system, service quality, and influencing factors, but the impact of service quality models and indicator systems is low. Then through the integration and induction of scholars&amp;rsquo; research progress on home care services, existing problems in service quality, and service quality evaluation index systems, in order to continue to innovate on the basis of existing knowledge, improve the service quality index system, and focus on combing process indicators with outcome indicators effectively, thereby improving the quality of community home care services.

Is low cost really conducive to primary care utilisation: An empirical analysis of community health centers in China.

Despite community health centers (CHCs) having many potential benefits, their utilisation rate is still low in urban China. Using the health belief model, the study conducted cross-sectional survey to examine factors that affected individuals' intentions to use primary care services in China. This study on 942 participants from Shanghai revealed that low cost had insignificant effect on the choice of CHCs once other key factors were accounted for. Older age, greater perceived susceptibility to contracting common diseases and more benefits of individualised care greatly increased the likelihood of using primary care services. Perceived low competencies of medical personnel along with outdated medical facilities had significant negative relationships with the intention of choosing CHCs. Based on these findings, some policy recommendations are proposed such as promoting education on prevalence of common diseases, recruiting qualified medical personnel, increasing professional training and cooperation, updating medical facilities, and offering high-quality individualised care in order to improve efficiency of primary care utilisation.