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A Study On The Construction Of Long - Term Care Model For Disability In China

Posted on:2015-01-18Degree:DoctorType:Dissertation
Country:ChinaCandidate:Y DingFull Text:PDF
GTID:1106330461499800Subject:Labor economics
Abstract/Summary:PDF Full Text Request
Old aging and longevity associated with unhealthy is characteristics of China’s fast-growing Ageing population. As of the end of 2013, there are 14.33%,9.40% and 0.58% of total population older than 60,65 and 85 years respectively. According to the "2008 Fourth National Health Services Survey", in China’s 60 years old and above,60% to 70% have chronic diseases,15% with severe illness, not only that, disability rate of the population aged over 60 is 3.6 times the disability rate of the total population. "China Aging Industry Development Report (2014)" shows that China’s disabled elderly has more than 37 million with more than 3% per year rate of rapid growth as of 2013, disability and disabled elderly will break through 46 million in 2020. Thus, the problem of long-term care for disability is seriously. With the economic and social development and improvement of living standards, long-term care needs of disabled elderly is increasing and increasingly showing a diversity of features.Meanwhile, the Chinese government has begun to pay attention to the issues of long-term care for disabled elderly and has introduced many documents, for example, "the suggestion of how to speed up the development of pension services industry", "the ’Twelfth Five-year’Plan for social services system for the elderly (2011-2015)", "a number of suggestion of acceleration of the development of pension services industry" etc. In these documents, the government repeatedly stressed the importance and urgency of issues of care and nursing issues for elderly, clearly encourage and support the operation of age care and hospice services, what is more, proposed to give policy support for agencies of elderly care and hospice services based on the actual situation. However, so far, because the establishment of long-term care for disabled elderly had a late start, it has being a short developing time and a slow developing speed, which due to China has not yet mature long-term care model, relevant discussion about long-term care for disabled elderly was only scattered in government pension services documents. Existing supply mode for long-term care cannot be completely matched with the demand of disabled elderly, whatever it is home care, community care or institutional care. The situation not only led to a lot of waste of long-care resources, but also cannot matched with the demand of disabled elderly.In the above background, the problem of long-term care of the disabled elderly, not only increasingly become the focus of attention, and largely determines the success or failure of the government pension career, but also the focus of academic research.At present, our research on disabled elderly long-term care model is still in its infancy, research methods used remained mostly descriptive analysis of the phenomenon, or a general analysis of macroeconomic theory, the discussion focused on the current situation of supply and demand and the existence of a pattern problem, introduce international experience and its Implications for China and so on. On how to deal with the relationship between the traditional family care and other social care approach between the way of care, how to locate the few studies of the different main responsibility for long-term care and other aspects of how disabled elderly by building long-term care model as a whole to meet the needs of the diversity of disability literature elderly more uncommon.In view of this, this paper build mode disabled elderly long-term care for the purpose of long-term care from the comb mode Evolution development in China start to analyze the relationship between the needs of disabled elderly and long-term care between modes is the logical starting point, first expounded different categories of disabled elderly general demand and the demand for long-term care of particularity; by PEST and SWOT method method to analyze the microscopic characteristics of the existing long-term care in different ways and in which the macroeconomic environment, and elderly people with disability match the diverse needs analysis. Then, ordered probit model and build structural equation model to analyze the resulting data questionnaire study mode disabled elderly long-term care needs of the wishes of its influencing factors. On this basis, summarize and learn from the experience of developed countries and regions, long-term care model, based on the basic theory of needs theory, welfare pluralism theory, equity theory, theory of planned behavior and rational choice theory, based on "both to meet disabled elderly principles hope home care wishes, but also to meet the needs of their diversity, "the proposed construction of the basic ideas of disability elderly long-term care model, build a disabled elderly Desire-based long-term care model, and the use of Peking University provided CLHLS2008 and 2011 micro-panel data, through the establishment of the transition probability matrix to track the health status of the elderly in the state transition, combined with forecast 2013 Comparative Analysis of Chinese elderly population data before and after the number of beds needed to build long-term care model demonstrates the pattern of feasibility. Finally, the country build mode disabled elderly long-term care policy recommendations. The main results and conclusions of this paper can be summarized as the following six:First, the internal disabled elderly population holistic and personalized features, the demand for long-term care model is also showing the similarities and heterogeneity. Overall, the majority of disabled elderly at home or want to familiarize yourself with the community to accept the long-term care, unless a last resort, can be lost very few are willing to take the initiative for the elderly long-term care facilities. Degree in physical disability, family status and the prevalence of care as the classification criteria, the disabled elderly classification after further analysis, a simple home care, home care, community care, institutional care methods were unable to meet the diversity of disabled elderly of long-term care needs. One for home care, the population policy since the 1970s implemented the reform and opening combined with accelerating social mobility, family function in disabled elderly long-term care in the increasingly weakened. The second is for home care, its intention is to ensure the establishment of disabled elderly families to enjoy both the spiritual solace, but also to get long-term care professionals, and reduce the burden on family caregivers, and improve long-term care of the disabled elderly quality and efficiency. But in reality due to the lack of specific content, lack of medical care and rehabilitation function and other reasons, can not provide long-term care for the sick of disabled elderly, and the role of substitute family care is very limited, in many cases family caregivers still take a lot of care task, and even still the main task of those who assume care. Third, community care for it, there is also a similar problem cohabitation home care, can not provide adequate and quality services for home care supplies, unable to meet the long-term disabled elderly home care needs, which can not really rely on to achieve its function. Fourth, care for the body, it can provide specialized for disabled elderly, systematic long-term care, but because of lack of spiritual solace, overcharging, contrary to the traditional Chinese family complex structural imbalance between supply and demand as well as other issues, still not disabled elderly pro-Lai. Thus, any kind of long-term care alone dependent manner disability were unable to meet all the needs of long-term care for the elderly, both to build a long-term holistic and personalized care model is imperative.Second, factors disabled elderly long-term care model needs can be summarized as the following three aspects:First, disabled elderly have their own objective conditions and their assessment of the objective environment. Sex, marital status, physical condition, disabled elderly living conditions significantly affect their long-term care model needs, women, the disabled elderly spouse, good physical condition, non-disabled elderly living alone, and families prefer and long-term care of children is closely linked manner; the second is the different level of understanding of long-term care patterns and attitudes. For most of the disabled elderly, their understanding of home care, community care, institutional care, the more objective evaluation of the higher, the more likely to choose these types of models to supplement or even an alternative to the increasingly weakening of family care; the third is to select a long-term when caregivers feel outside pressure mode. Disabled elderly themselves, their children, neighbors and friends do not exclude the more they stay long-term care facilities, the more they are likely to choose to contact the family and children do not close the way long-term care.Third, combing and research in Hong Kong, Taiwan, Japan and the United States after long-term care model found that long-term care patterns starting early in these countries and regions, developed and accumulated a wealth of experience, compared to the mainland of China yet mature long-term care model, the existing long-term care the way the concept is not clear presence, poorly designed and inadequate supporting facilities such issues as the lack of professionalism in the development. Thus get the following revelation:Construction of disabled elderly long-term care when model should take full account of conditions in the premise, focusing on the concept of long-term care, legislative support, participation and diversification of long-term care body positioning and other aspects of the relationship.Fourth, the study needs to respect the wishes of disabled elderly as a starting point, based on systematic, rights, fairness, selective and gradual manner, both to build a disabled elderly hope to meet the wishes of home care, and to meet their long-term care model needs diversity. The model of family care as the core of home-based care, community-based care, institutional care as a support to supplement the family bed, specifically including eight kinds of ways:family care, home care, community care, nursing homes, home care and home the binding beds, home care and home beds, community and home care beds and nursing homes combined. Which corresponds to the family care is not needed medical care and adequate family care resources disabled elderly; home care is mainly applied in mild, moderate disability, no medical care, and there is no adequate family care resources for the elderly; community care is mainly applied in mild, moderate disability, no medical care, and home care for the elderly with limited resources; nursing homes mainly severe disability, family care resources are scarce and do not require complex medical care of the elderly long-term care; home care and home beds combining targeted simply adequate medical care and family care resources disabled elderly; home care and family bed combines mainly for mild, moderate disability, lack of resources and the need for a simple home care medical care for the elderly; community and family care beds combines mainly for mild, moderate disability, family caregivers need a simple lack of resources and provide medical care for the elderly long-term care; nursing homes mainly for severe loss of energy and the need for complex medical system care for the elderly.Fifth, to disabled elderly Desire-based long-term care model is feasible, can effectively alleviate the elderly future disability, family caregivers reduce the supply of long-term care beds in nursing homes and nursing homes to pressure brought. According to the relevant estimates, the long-term care model allows nursing homes and nursing home beds in the supply pressure reduced by about 75%. Moreover, this model is more important is to respect the wishes of energy loss needs of the elderly, and uphold the "continuum of care" concept; at the same time, the family followed the principle of priority, to minimize the living environment due to changes to bring disabled elderly inconvenience and maximize their elderly relatives, neighbors and friends exchange between certain extent, to avoid their spiritual loneliness. In practice, play an effective long-term care for the elderly disability mode function needs long-term care system with other components of coordination, therefore, need to re-interpret and Xuanchuan Xiao culture, promotion of traditional cultural values and the actual situation in coordination; also need to improve support of policy, legal, financial and other aspects of the rich content of long-term care, to provide personnel and material security, the formation of social progress and positive interaction between economic development and long-term care coordination between supply and demand, and only this, in order to truly achieve pattern design mind.
Keywords/Search Tags:disabled elderly, long-term care, model, build
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