Quality Evaluation Of Government Purchasing Elder Home Care Services

Public services outsourcing is one important policy tool in governance management toolbox.In order to meet the challenges of aging population and to ensure the life quality of the older people,many local authorities in China began to purchase elder home care services from the social sectors since 2000.However,there are some drawbacks in local authorities,the social sectors and the outsourcing systems,which bring about a lot of risks for the quality of elder care services.Therefore,we must evaluate the quality of elder care services during the outsourcing since evaluation can help us understand the process of elder care service and discover the problems of the services.According to the result of the quality evaluation,the local authorities and the social sectors can adjust the outsourcing directions and promote the quality of elder care services.There are several important questions involved in the quality evaluation of government purchasing elder care services.The first is how is the evaluation of government purchasing elder care services going in China.The second is what is the value orientation of quality evaluation government purchasing elder home care services?The third is what theory to use to establish a set of quality evaluation factors system.This research uses Avedis Donabedian's structure-process-outcome theory to establish a new evaluation factors system.The fourth is what is the quality evaluation model and indicator system of the government purchasing elder care services.The fifth is what is the quality of government purchasing elder care services according to the evaluation factors system.These five questions are the research questions of this study.According to the above research questions,the research approach of this study is why to evaluate,how to evaluate and what the result of the evaluation.To put it specifically,the first is to analyze the policy evolution path and three models of elder care services contracting in China in order to have a clear understanding of elder services contracting.The second is to study how to establish a quality evaluation model,which involves the values orientation,the theory basis,the dimensions and the specific indicators.When a new evaluation model is designed,the next step is to testify it using the empirical data.According to the new and testified quality evaluation model,what factors influence the quality and what is the relationship among structure,process and result and what is home elder care service quality of Nanjing and Nanchang can be assessed and evaluated.This paper is consisted of seven chapters.The first is introduction,which displays the background,the research significance,the literatures,the research methods and research framework.The second and third chapters are the logical starting point of quality evaluation of government purchasing elder care services,which describe the history and development of home elder care services outsourcing in China and the value orientation and theory basis to evaluate the quality of government purchasing elder care services.The fourth chapter and fifth chapter are about how to evaluate the quality of government purchasing elder care services.Chapter 4 is to describe what the evaluation model and factors system are and Chapter 5 is to verify the evaluation model and test what factors influence quality and the relationship among structure,process and result.Chapter 6 is to display the evaluation results of Nanjing and Nanchang and the last chapter is the research conclusions,some policy suggestions,research limits and future research prospect.The conclusions of this study are as follows.The quality evaluation model designed according to Avedis Donabedian's structure-process-outcome theory is scientific and effective.The structure,process and result are related.The evaluation result according to the evaluation factors system shows that Nanchang's quality is higher than Nanjing's.In order to improve the quality of government purchasing elder care services,several improvements need to be done.First is to promote quality standardization of government purchasing elder home care services.Second is to establish a special quality evaluation committee in government such as CQC in the UK to make the evaluation more professional and effective.Third is give more training to the workers who give care to older people,which will help to strengthen their professional knowledge and make the services more caring,more responsive and safer.Fourth is to improve the elder care services demand survey,which will help to improve the supply and demand matching degree.However,this research has some limits,such as the concept of definition is not comprehensive enough,the sample number is not big and the conclusions is proper and right just in limited area.The future research can explore more social care quality evluation methods and ways in developed countries,construct and demonstrate the unified national elder home service quality assessment model,carry out comprehensive and rolling quality assessment policy experiments and evaluate the efficiency of government purchasing elder home service.