Community Care For The Elderly

The pressure of care of the elderly, derived from population aging, has become one of the most significant economic and social headline act confronted by China in the first half of 21st century. Community care, featuring human orientation, cost-effectiveness and social benefit, has evolved to be the key item in China's elderly care service. Based on welfare pluralism theory and by means of comparing Shanghai's community care policies and those enacted in Great Britain, Australia, Hong Kong and Taiwan, this thesis aimed to establish an analysis framework and explore the development pattern of community care model in Shanghai and even China as a whole.This thesis was divided into three parts, among which Chapter 1 and Chapter 2 constitutes the first part where the significance of topic selection was illustrated, existing research documents were reviewed and the analysis model was hammered out; the second part ranged from Chapter 3 to Chapter 7 and would be the main body of the thesis, in which five theme subjects were elaborately born down on; the final part were concerned with the conclusion and prospects. Those research content and conclusion could be summarized as follows:Chapter 3 systematically dealt with the evolution process of community care, about its definition and generated policies, while reviews and analysis were given to the community development routine in China. In the light of the above conclusion, policy meaning, development routing and value of community care in developed industrial country were further expounded as well as in China.Chapter 4 analyzed the community care items in those four cases and a sort of convergence was discovered, namely logic progressive maintain-enhance-empowerment relationship, which meant an expansion from maintaining daily life styles to enhancing individual living capability and empowering social living capabilities.In Chapter 5, the system of organization and delivery was explored and the conclusion was that the governments were always playing the main role in the system, especially for the parts of planning, construction and funding. In Great Britain, Australia, Hong Kong and Taiwan, the main providers of community care service were independent sectors, especially independent nonprofit organizations and a contract between purchasers (governments) and providers was engaged. In Shanghai, however, the main providers were non-state enterprises, which are semi-official and are largely attached to governments.In Chapter 6, the research on eligibility and coverage of public funding service revealed that eligibility in Shanghai is the needs based on means-test while in the other four cases it is the means-test based on needs. The former is of residual social welfare services while the latter belongs to universal social welfare services. As for the scope of beneficiaries within public funding service, there appears synchronization between the scope and economy development level.Chapter 7 analyzed the funding structure and maintained that, in those four cases, the higher profile the governments belong to, the more funding responsibilities they will take; while in Shanghai, a reverse tendency is taking place and the disparity between higher and lower governments level is prone to being broadened all the more. From the perspective of funding approaches, those four cases have mainly adopted contract-out including competitive tendering and invited proposal; nevertheless, in Shanghai where a quasi-market model has not established yet, the government purchases service from appointed enterprises by close-styled voucher. For the part of user fee, diversified user fee arrangements in those cases demonstrated two distinct hypotheses about who the ultimate care responsibility should be ascribed to: individuals or the public sectors.Finally, the approaches likely adopted and constraints probably encountered in promoting Shanghai community care service were investigated.