A Research On The Regional And Group Difference Of The Home-based Community Care Need For The Aged

Since 1999,our country has evolved into an aging society.The population of aging people keeps growing with a high speed in recent years and the aging problem becomes more and more serious.In particular,the aging problem in rural areas is even worse than that in urban areas.It is predicted that the ratio of aging people above 60 years in rural areas will be up to 20.6%by 2020,and it will arrive at 30.1%by 2030.Such a situation will continue until around 2045,and then the aging problem in urban areas will become worse than that in rural areas.The transfer of rural labor makes the aging situation much more serious,and it also degrades the capable of the traditional pension for the aged.As the economy is fairly underdeveloped,the western region is always the main areas where rural labor transfer happens.Therefore,the aging people living there would suffer more risk of pension,and thus it is urgent to employ social endowment services to recover the capable of family supporting.Among the various ways of social supporting for the aged,community-based home care(CBHC)is the most favorite way due to its ability to satisfy the need that the old people can acquire the services in the neighborhoods.Hence,there are more needs of social supporting as well as CBHC in the less developed regions.Nevertheless,the development of CBHC in rural areas would be strongly limited by their budget constraint.As such,it is of great important to build a development pattern of CBHC based on the practical situation of rural areas.It is expected that such a pattern has the ability to utilize the supporting resource for elderly efficiently and also can be applied to different areas and groups.Obviously,it is an urgent mission needing continuously exploration to achieve the above vision.This paper investigates the need of CBHC for the aged in rural areas from the perspective of regional and group difference.It follows three ways to carry on our studies:firstly we give an overall perspective to demonstrate the influence factors of need in CBHC;secondly we show how the regional difference between the suburban areas and the exurban areas imposes influence on such needs;thirdly we reveal the impact of group difference on the need by investigating two special groups,empty nesters and elderly women.Based on the above studies,this paper proposes a development pattern of community-based home care based on the regional and group difference.Accordingly,some strategies are presented to improve the efficiency of providing CBHC.To begin with,we give a survey of the literatures in the field of CBHC,and define the concepts will be used in this paper.By introducing the theories of need,social support,regional unbalanced economic growth and empowering,the theoretical framework of this paper is founded to investigate the need of CBHC in rural areas.Then,we give an introduction of the research areas and describe the basic situations of the implementation of CBHC in rural areas.By analyzing the investigation data in the research areas,some results about the need of CBHC are presented.As for the need characteristics and the corresponding influence factors,we show that the whole need of CBHC in rural areas is with a low level,and the personal features,family features,economical conditions as well as the living space of the aged are the main factors that affect on the need of CBHC significantly.While for the regional difference of the need,it is shown that there is a significant difference of the pension resource between suburban areas and exurban areas.Also,the need of CBHC for the aged is different when the aged lives in different areas,e.g.,in suburban areas or exurban areas.In general,when the family has the ability of providing rich endowment resources to the aged,accordingly it requires less CBHC for the aged.Hence,the endowment resources provided by family have a significant influence on the need of CBHC,especially for the aged living in exurban areas.Now we turn our sight to the group difference of need in CBHC.We find that the outmigration of young rural labors is the critical cause for the occurrence of the empty nesters,who would undergo severe challenges in their endowment.Compared with the aged with children around to look after them,the empty nesters have a lower life satisfaction and also need more CBHC to improve their life quality.We further find that such needs of CBHC for empty nesters are affected by their healthy conditions and the situation that their children work far away from home significantly.Apart from empty nesters,elderly women who has weak economic and healthy conditions,is another important vulnerable group in rural areas.Moreover,the proportion of elderly women who is widowed is higher than other populations.These conditions make the elderly women face to an even worse situation of endowment.It seems that the elderly women would have more need of CBHC;however,it is interesting that it does not happen in reality.The economical conditions still play an important role in affecting the need of CBHC for the elderly women as the other populations.Finally,we present a development scheme of CBHC built on the basis of regional and group difference,and give some strategies accordingly.Obviously,the community is the most important foundation of the CBHC.However,the community construction in rural areas is fairly insufficient and such conditions will last for a long time.Therefore,the first thing we need to do is to enhance the capacity of the rural primary organization and establish social organizations.Since the suburban areas and the exurban areas are with different levels of development of social economic and cultural conditions thanks to the geographical relationship,the CBHC construction should focus on different emphasis for different areas.The suburban areas can give priority to establish the regional endowment service center which can support diversified services for the aged.In contrast,the exurban areas are encouraged to establish dispersive service centers working in mutual mode.Unlike the regional endowment service center in the suburban areas,the service centers in exurban areas are planned to provide basic pension services to the aged.In order to provide the CBHC in an efficient way,obviously,it should determinate the items of CBHC according to the need level of the aged.Another important thing is to establish a bridge between needs and services by creating personal data of the aged.This helps the centre of CBHC to realize the actual need of the aged and to receive feedback about the provided service from the aged.Therefore,the utility of public goods for pension services will be maximized.Note that,needs are the basis of demands,and the transform from need to demand relies heavily on the economic conditions of the aged.However,in a long time,the current endowment insurance system for urban and rural residents aided to guarantee the basic financial security of the aged cannot play an important role in obtaining the social pension services.Therefore,the government should increase pension according to its financial capacity and the corresponding needs of the aged.Meanwhile,the payment mechanism of endowment insurance system can make some adjustions to improve its attraction,and thus the accumulation of the personal account can be increased accordingly.Besides,the suburban areas should promote the development of collective economic to enhance the economical capacity of its community.And,it can encourage its landless peasants to participate commercial insurances.While for the exurban areas,it is reasonable to formulate a policy in increasing farm subsidies of the aged on the basis of their farming dimensions.