Care Service System Research Articles

ЗАСТОСУВАННЯ ПРОГРАМ ДОПОМІЖНИХ РЕПРОДУКТИВНИХ ТЕХНОЛОГІЙ В УКРАЇНІ: УПРАВЛІНСЬКІ АСПЕКТИ

The article discusses managerial aspects of the use of assisted reproductive technology programs in Ukraine. It was noted that it is now critically important for the natural recovery of the population of Ukraine to do everything possible to expand access to treatment, diagnosis and prevention of infertility, in particular with the help of programs of assisted reproductive technologies. It was determined that currently in Ukraine the most active subjects are service providers who determine the direction of development of management relations in the field of application of assisted reproductive technologies. The need to intensify the activities of the authorities regarding their role as a regulator of social relations within their competence is emphasized. Attention is focused on the development of a balanced regulatory toolkit of management, i.e. regulatory and legal acts of different legal force, follows organically from this. Attention was also drawn to the broad context of management in the field of application of assisted reproductive technologies. It is argued that within the scope of determining the priority directions for improvement of management in the field of application of assisted reproductive technology programs in Ukraine, it is expedient to develop not only medical, but also socio-humanitarian and socio-economic research on the evidence of certain reproductive health management practices. It is emphasized that in modern realities, the context of post-war reconstruction should also be taken into account in order to determine the ways of development of management in the field of application of assisted reproductive technologies. It was concluded that in order to ensure the high-quality functioning of the health care sector in the current realities, several options for solving the most acute problems are proposed: strengthening decentralization; expanding the space of freedom for autonomous work of doctors; establishment of coordination of activities between all links of medical care; introduction of new roles in the system of health care services; mental health as priorities for state funding.

Rest-in-Peace: Research on the Architectural Types and Design Ideas to Guide Design of Hospice Care Building.

In the context of an aging population, the concept of peaceful end-of-life care has gained increasing significance as an essential component of individuals' fundamental well-being. This underscores the importance of researching and developing hospice care facilities and service systems dedicated to providing a tranquil resting environment. This study focuses on selected hospice care buildings, examining their service model evolution and architectural design. Through case analyses, it explores contemporary hospice care architecture, identifying various types and spatial design features that cater to the end-of-life needs of individuals. The findings guide the design of hospice care buildings in China, emphasizing patient-living areas, medical care zones, and auxiliary functional spaces. This comprehensive approach aims to enhance terminally ill patients' comfort, serenity, and dignity. Moreover, it aims to provide emotional and post-funeral support to terminally ill patients' families.

Optimization of Shanghai Elderly Care Service System Platform under the Background of “One Network Unified Management”

Optimization of Shanghai Elderly Care Service System Platform under the Background of “One Network Unified Management”

Research on the Construction of Provincial Basic Elderly Care Service System from the Perspective of Policy Tools

Research on the Construction of Provincial Basic Elderly Care Service System from the Perspective of Policy Tools

Research on the Construction of Elderly Care Service System in Fujian Province under the Background of Population Aging

Research on the Construction of Elderly Care Service System in Fujian Province under the Background of Population Aging

A Study on the Dilemma and Path of Rural Elderly Care Service System Construction from the Perspective of Rural Revitalization

A Study on the Dilemma and Path of Rural Elderly Care Service System Construction from the Perspective of Rural Revitalization

The public health insurance funds as drivers for integrated care

The public health insurance funds are a unique player in the healthcare landscape. Belgium has seven public health insurance funds that operate the reimbursement system of health care services covered by the compulsory health insurance for their members and the payment of a replacement income in case of long-term illness. Public health insurance funds are present throughout the lifespan of their members, from birth to death, they are companion and point of contact for crucial moments in life at all ages.They play a key role in the rollout and implementation of key aspects of integrated care. 
 Not only are they responsible for the health care reimbursement, they are the guardians of the health insurance finance as well as the administrator. They are in control of the recognition and follow up of patients in incapacity for work and guide those patient in return to work and rehabilitation and reintegration. They have lots of experience in finance mechanisms and regulation within health care. 
 Next to their responsibilities in reimbursement, there’s also an important social service. The social workers are there to familiarize people with care, the organization of home care and to facilitate all preconditions to make this possible, but also to determine the severity of care and to open up as many social benefits as possible for those who are entitled to it. The public health insurance funds also generate data which they can use to evaluate the health system, provide for scientific research but also use to enhance population management and to weigh on decision- or policy makers. 
 After a short, interactive part, we will explore these different roles and demonstrate how they contribute to integrated care. Not only from the perspective of the public health care insurance institutions, but also from the perspective of collaboration amongst formal care givers surrounding one patient and from the perspective of several informal care givers. By using various testimonials, we let informal care givers share their experience and needs about integrated care.
 Despite the long history, many actors in Belgium are insufficiently aware of what exactly these different roles are. It is the task of the public health insurance funds to continue to fully focus on this and to participate in initiatives that can realize integrated care. Therefore, at least one good practice will be discussed from one of the 12 integrated care pilot projects in which the funds, together with the other care actors and the government, are looking for innovative actions to make integrated care possible.

ELDERLY CARE POLICY IN CHINA: ITS EVOLUTIONARY PATH AND IMPLICATIONS ON GOVERNANCE

Abstract Over the years, the Chinese elderly care policy has undergone significant changes, leading to the systematic development of a comprehensive elderly care service system. This study explores the pivotal policies formulated by central policy-making bodies and examines the historical and current state of the elderly care system in China. The findings demonstrate a consistent alignment between the system’s evolutionary trajectory, the practical expectations of the population, and the Communist Party of China’s (CPC) objective of fostering a unified and balanced society. The study also highlights inherent issues concerning governance mechanisms and role-position within the system. Notably, we highlight the successful protection of older adults during the COVID-19 pandemic as an exemplary care of care service provision and draw lessons from international experience.

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.

PEMODELAN PROSES BISNIS SISTEM LAYANAN PADA PT. TASPEN (PERSERO) PALEMBANG

The Taspen Care service system of PT. Taspen Persero is a crucial component of the business's efforts to give participants the best service possible. To increase operational effectiveness, customer happiness, and accountability, it is essential to have a thorough grasp of the business processes involved in providing these services. This study aims to model the business processes found in the Taspen Care service system using BPMN. It is simpler to grasp the study by using the industry standard for visually describing business processes, known as BPMN. The technique employed entails phases for business process identification, data gathering, and BPMN modeling. A thorough and organized modeling of the Taspen Care service system business processes is the end result of this research. Decision-making can benefit greatly from this modeling.

노인장기요양서비스 평가체계의 변화에 관한 연구

The evaluation system for South Korea's long-term care services for the elderly was reorganized with a focus on services quality management through the long-term care facility evaluation system following quasi-marketizing reform in the late 2000s. However, unlike the old evaluation system, service quality is managed through the evaluation of providers who voluntarily entered the market, and this provider evaluation is conducted in connection with the benefit provision process by the insurer (National Health Insurance Services) as a characteristic of South Korea. With regard to the evaluation system, there is dissatisfaction with provider evaluation, and it is argued that a separate independent dedicated evaluation organization should be established together with the strengthening of the role of local governments.
 Therefore, taking notice of cases in Japan, which is introducing an evaluation system that is different from the one in South Korea, this study is intended to examine how the evaluation system for long-term care services for the elderly in Japan has been reorganized and changed in comparison with South Korea and find implications for South Korea. To that end, this study will analyze how the institutional devices for various evaluations such as the third-party evaluation system, the policy evaluation system, and the evaluation system for long-term care insurance business plans for the elderly have been reorganized to be pluralistic and multilayered in the institutional reform following quasi-marketization reform in Japan. Second, it will derive the fact that objective-based policy evaluation (=performance management) and participatory evaluation are being strengthened amid changes in policies regarding the evaluation system for long-term care services for the elderly in Japan. Third, it will capture the governance structure of the evaluation system by revealing the intergovernmental and inter-institutional linkage structure of Japan's evaluation system. Fourth, by identifying the functions carried out by the evaluation system through cases in Japan, this study will present policy implications that will enable the problems of South Korea's evaluation system to be overcome.

Investigating the association between characteristics of local crisis care systems and service use in an English national survey.

In England, a range of mental health crisis care models and approaches to organising crisis care systems have been implemented, but characteristics associated with their effectiveness are poorly understood. To (a) develop a typology of catchment area mental health crisis care systems and (b) investigate how crisis care service models and system characteristics relate to psychiatric hospital admissions and detentions. Crisis systems data were obtained from a 2019 English national survey. Latent class analyses were conducted to identify discernible typologies, and mixed-effects negative binomial regression models were fitted to explore associations between crisis care models and admissions and detention rates, obtained from nationally reported data. No clear typology of catchment area crisis care systems emerged. Regression models suggested that provision of a crisis telephone service within the local crisis system was associated with a 11.6% lower admissions rate and 15.3% lower detention rate. Provision of a crisis cafe was associated with a 7.8% lower admission rates. The provision of a crisis assessment team separate from the crisis resolution and home treatment service was associated with a 12.8% higher admission rate. The configuration of crisis care systems varies considerably in England, but we could not derive a typology that convincingly categorised crisis care systems. Our results suggest that a crisis phone line and a crisis cafe may be associated with lower admission rates. However, our findings suggest crisis assessment teams, separate from home treatment teams, may not be associated with reductions in admission and detentions.

Does home and community-based services use reduce hospital utilization and hospital expenditure among disabled elders? Evidence from China.

In the background of aging in place, home and community-based services (HCBS) have been playing an increasingly important role in long-term care (LTC) security systems. However, it is still uncertain whether and how HCBS use affects hospital utilization and the corresponding expenditures. Using data from the China Health and Retirement Longitudinal Survey (CHARLS) and the China City Statistical Yearbook, the instrumental variable (IV) approach is applied to identify the causal effects of HCBS use on hospital utilization and hospital expenditure among disabled elders. We find that HCBS use significantly reduces the probability of being hospitalized, the times of hospitalization, and the length of inpatient stay, as well as the total, out-of-pocket and reimbursement inpatient expenditures, demonstrating not only the substitution impact of HCBS for hospital care but also the effectiveness of medical expenditure control in LTC security systems. Heterogeneity analysis shows that the impacts of HCBS use on hospital utilization and hospital expenditure concentrate on disabled elders who are younger, male, living in urban areas, or from higher-income households; both healthcare and spiritual consolation services have significant negative effects, while the anticipated effects of daily care service use are not supported. The possible mechanisms are the substitution of HCBS for hospital care and the improvements in both the physical and psychological health of disabled elders. However, the mechanism of adverse events decrease is not verified, which needs to be investigated further with more proxy variables. This study provides empirical evidence that HCBS use can not only reduce hospital utilization and hospital expenditure among disabled elders but also improve their physical and psychological health. Policy designs should emphasize the orientation of HCBS, ensure the fundamental and central position of HCBS in the formal care service system, pay more attention to the accessibility and affordability of HCBS for fragile groups, and diversify and optimize the development of the health service and the spiritual consolation service.

系统仿真视角下平顶山市城市社区养老托育服务供给研究

With the increasing trend of aging and fewer children in society, China’s population structure is facing severe challenges. After the official implementation of the “Three Child Policy” in 2021, Pingdingshan City is facing the problems of how to provide effective community services, meet the needs of the elderly and children, and promote harmonious community development. In September 2022, Pingdingshan City formulated a comprehensive solution titled “one old and one little” to carry out supply side structural reform. The main content is to establish a bottom line through social security coordination, promote universal benefits, by mobilizing various forces from the government, market, and society to achieve a market-oriented coordinated development path. It has continuously made new progress in providing for the elderly and children. This article revolves around three dimensions: the supply and demand of urban community elderly care services, the factors that affect urban community elderly care, and policy suggestions. By studying literature and organizing data, a simulation model is established. Through model analysis, the influencing factors of the functional performance of the urban community elderly care service system are ultimately identified, and countermeasures and suggestions for improving the urban community elderly care service system are proposed. I hope it could ensure the supply and demand of future elderly care services, and find a balance between economic development and social security.

Smart Floor Mats for a Health Monitoring System Based on Textile Pressure Sensing: Development and Usability Study.

The rise in single-person households has resulted in social problems like loneliness and isolation, commonly known as "death by loneliness." Various factors contribute to this increase, including a desire for independent living and communication challenges within families due to societal changes. Older individuals living alone are particularly susceptible to loneliness and isolation due to limited family communication and a lack of social activities. Addressing these issues is crucial, and proactive solutions are needed. It is important to explore diverse measures to tackle the challenges of single-person households and prevent deaths due to loneliness in our society. Non-face-to-face health care service systems have gained widespread interest owing to the rapid development of smart home technology. Particularly, a health monitoring system must be developed to manage patients' health status and send alerts for dangerous situations based on their activity. Therefore, in this study, we present a novel health monitoring system based on the auto-mapping method, which uses real-time position sensing mats. The smart floor mats are operated as piezo-resistive devices, which are composed of a carbon nanotube-based conductive textile, electrodes, main processor circuit, and a mat. The developed smart floor system acquires real-time position information using a multiconnection method between the modules based on the auto-mapping algorithm, which automatically creates a spatial map. The auto-mapping algorithm allows the user to freely set various activity areas through floor mapping. Then, the monitoring system was evaluated in a room with an area of 41.3 m2, which is embedded with the manufactured floor mats and monitoring application. This monitoring system automatically acquires information on the total number, location, and direction of the mats and creates a spatial map. The position sensing mats can be easily configured with a simple structure by using a carbon nanotube-based piezo-resistive textile. The mats detect the activity in real time and record location information since they are connected through auto-mapping technology. This system allows for the analysis of patients' behavior patterns and the management of health care on the web by providing important basic information for activity patterns in the monitoring system. The proposed smart floor system can serve as the foundation for smart home applications in the future, which include health care, intelligent automation, and home security, owing to its advantages of low cost, large area, and high reliability.

The impact of community care services on older people's psychological health: an empirical study in Liaoning Province, China.

Rapid population aging in China means it is imperative to establish a comprehensive care service system for older people. Currently, China is vigorously promoting the development of community care services for older people which should, ideally, focus on psychological health in addition to physical health. This study examined the impact of community care services on older people's psychological health. Survey data (n = 741) were collected from people aged 60 years and older in Liaoning Province, China, in which various community care services for older people were provided. Information was collected regarding the types of services provided (e.g., meal services, medical and social care), participants' demographic details (age, gender, economic circumstances, etc.), and their psychological health (e.g., loneliness, life satisfaction). The impact of the various care services on older people's psychological health was subsequently examined through the construction of a structural equation model. Community care services for older people had a significant positive impact on their psychological health, with the most significant positive impact on cultural and sports activities, visiting and chat services, and emotional counseling. The impact of community care services on sub-groups of older people (e.g., those who were disabled, socially isolated and/or poor) was different. It is necessary to provide comprehensive and high-quality community care services, organize diverse cultural, sports, and recreational activities, provide differentiated and specific services for older people, and formulate corresponding service guidelines.

Informal Caregiving in Adolescents from 10 to 16 Years Old: A Longitudinal Study Using Data from the Tokyo Teen Cohort.

There is growing evidence of the impact of informal caregiving on adolescent mental health, and its role is often hidden unintentionally or intentionally, which may hamper early identification and support for young informal caregivers. However, the quantitative evidence regarding household factors relating to informal caregiving has mostly been based on cross-sectional findings. This study examines the longitudinal associations between household characteristics and the duration of informal caregiving in adolescents from 10 to 16 years of age. Child-household respondent pairs (n = 2331) from the Tokyo Teen Cohort in Japan were followed every 2 years from 10 to 16 years of age. Informal caregiving was assessed repeatedly based on the household respondent's survey responses. Persistent caregiving was defined as daily caregiving at two or more waves. There were 2.2% of children who gave daily care at two or more waves. Cross-sectional associations with daily informal caregiving at each wave were found with girls, low household income, and cohabiting with grandparents. A significant association with persistent caregiving was found only in cohabiting with grandparents at 10 years of age after adjusting for sex, number of siblings, single parent, and household income. Our longitudinal examination highlighted cohabiting with grandparents as a preceding factor for persistent caregiving. Identification and support for young informal caregivers should be integrated into social care service systems for older adults. The mechanism of persistent caregiving requires clarification.

한국과 주요국의 웰다잉(Well-dying) 지원정책의 현황과 시사점

This study examines the recent trends in major countries through overseas case studies related to well-dying support policies and hospice/palliative care service systems in major countries, and draws implications through comparative analysis with Korea to suggest necessary improvement measures and policy recommendations. As a result of overseas case studies, major countries are promoting the provision of services centered on regional comprehensive systems and home care centered on regional base hospitals to improve the quality of death of members of society and support well-dying. In addition, a system was established to connect facilities related to well-dying support and provide diversified services, as well as provide an interconnection network for hospice and palliative care services. On the other hand, in Korea, the scope of death proposed by the legal and institutional foundation is still very narrow, and death is regarded as an event rather than a continuum of life, and the minimum legal and institutional foundation required for this is established. Therefore, we also need to gradually expand the legal and institutional foundation so that well-dying and preparation for a good death, which are closely related to the rapid progress of aging, can be realized. Above all, it is a limitation that the area of well-dying service that the domestic system is currently interested in is narrow, and policy interest in the psychological and social areas is still lacking, so it is possible to comfortably discuss death as an element of life rather than avoiding death. It is also necessary to create a positive social atmosphere, strengthen services for the remaining family members, and prepare a policy foundation. To realize this, it is necessary to make policy efforts to gradually overcome the narrowness of current interests and areas in a larger framework. In addition, there is a need to improve the system so that more diversified and comprehensive well-dying support can be achieved by developing it to suit our situation by referring to the cases of major countries.

요양보호사 양성 과정 교육생의 대체실습 교육 경험 연구

The purpose of this study was to improve the educational process to strengthen the professionalism of caregivers known to play a key role in the long-term care service system for the elderly. Therefore, in the process of fostering nursing care workers, characteristics of perceptions of those who experienced alternative practice were identified, typified, and explored through the Q methodology to confirm the meaning. In order to form the Q population, four study participants were interviewed in advance. Q samples on a total of 34 trainees' alternative practice education experiences were extracted through interview content and literature analysis. Q classification was conducted for 22 study participants. P samples were male and female trainees educated at the caregiver training center, 22 caregiver trainees with nursing assistant and social worker licenses corresponding to long-term care workers, and caregiver trainees corresponding to the general new class. Three recognition factors extracted by analyzing the data collected in Q sorting with the PC QUANL program explained 40.6% of the total variance. They were ‘rational inquiry’, ‘critical analysis’, and ‘realistic satisfaction’. According to implications of research results, this study proposes that it is important to improve the curriculum that can strengthen the professional competency of caregivers who respond to the era of integrated care in the community.

Integrating Artificial Intelligence and Wearable IoT System in Long-Term Care Environments

With the rapid advancement of information and communication technology (ICT), big data, and artificial intelligence (AI), intelligent healthcare systems have emerged, including the integration of healthcare systems with capital, the introduction of healthcare systems into long-term care institutions, and the integration of measurement data for care or exposure. These systems provide comprehensive communication and home exposure reports and enable the involvement of rehabilitation specialists and other experts. Silver technology enables the realization of health management in long-term care services, workplace care, and health applications, facilitating disease prevention and control, improving disease management, reducing home isolation, alleviating family burden in terms of nursing, and promoting health and disease control. Research and development efforts in forward-looking cross-domain precision health technology, system construction, testing, and integration are carried out. This integrated project consists of two main components. The Integrated Intelligent Long-Term Care Service Management System focuses on building a personalized care service system for the elderly, encompassing health, nutrition, diet, and health education aspects. The Wearable Internet of Things Care System primarily supports the development of portable physiological signal detection devices and electronic fences.