Research On The Demand Level And Satisfaction Strategy Of Community Home-based Care Service For Urban Elderly

Accurately identifying the service demand of the elderly is the essential part in the quality of community home-based care service,also a key link in its service supplying..It not only involves the rationality of service setting and the accuracy of supply-demand matching,but also directly affects the satisfaction and acceptability of the elderly.As an important mode which undertaking majority elderly service demand,community home-based care meets problems in operation,such as the lack of pertinence and accuracy,the mismatch between supply and demand.Those problems resulting in the lack of attractiveness of service and the potential service demand of the elderly cannot be fully released.Therefore,accurately identifying the service demand of elderly and giving priority to meet strategic arrangements are important for the development of community home-based care service,and is also a rational choice under the condition of limited social service resources.In the understanding of "demand",there are two forms of distinction,they are “need” and “want”.In terms of the demand of service for the elderly,“need” means the dependency on services;"Want" goes beyond the need,which means the expectation for service.Therefore,this article takes the demand of community home-based care service as the theme,aiming at the shortcomings of existing research,emphasizing the following points.Firstly,this paper analyzed the needs level,demand types and influencing factors of elderly demand motivation.Secondly,this article examined the tendencies between dependence and expectation of elderly.And prioritized the satisfaction of service demand from the perspective of dependency.Thirdly,according to the strategy of need priority satisfaction,this paper discussed how to identify demand objects,how to input service resources and how to provide services.There is a close logical relationship between the above contents,which are important and unavoidable problems in understanding and discussing the service demand of the elderly.Therefore,this paper analyzed the contents,types and the distinction between need and want according to Maslow's needs theory,ERG theory and human need theory.This article also discussed how to make operational distinction between "dependency and expectation" shown in "need and want" on the basis of attractive quality theory and its Kano's model.Then,based on the qualitative analysis of the policy,literature and the interview data,this paper constructed the demand framework of the community homebased care,which is the main content of the service demand analysis.Moreover,based on the questionnaire survey in Shanghai,Changsha,Kaifeng and Yinchuan,and semistructured interviews with the elderly and family,the staffs of the government,community and service institutions,this paper drew the following main conclusions and views.Firstly,the service demand of the elderly is relatively low,the tendency of "Expectation" is higher than "dependence".Based on the analysis of the need hierarchy with the Kano's model,2 must-be elements,4 one-dimensional elements and 5 attractive elements were divided,most of the services were indifference elements.The dissatisfaction index of most services is significantly lower than the satisfaction index.It indicates that the elderly still mainly dependent on informal services,and rarely dependent on formal services.Besides,the imperfection of the development of community home-based care service,the limitation of knowledge and experience of the service by the elderly,and the unformed acceptance habits are also important reasons for lower dependence.Secondly,the service demand of elderly are concentrated.Firstly,the demand for health care services are high.The daily living care services are higher than the spiritual care services,which reflects the difficulties faced by the elderly.Secondly,in terms of the service composition of must-be,one-dimensional and attractive elements,the demand of elderly showed 3 features separately,paying more attention to the basic service function,expectation access to disease prevention services based on accessibility of basic medical services,and expectation the convenient services around daily life.Thirdly,in all kinds of services,the demand of domestic services,care services and emergency assistance services are higher among the daily living care services.The demand for upstream and basic medical services are outstanding.And the demand tendency of self-satisfied services is obvious.In addition,the above demand characteristics are also consistent at the overall and group level.Thirdly,the hierarchy of needs of the elderly is gradually highlighted,and there is a significant difference in the "dependency" between groups.On the self-sufficiency and family satisfaction,the influence of each factor on the demand is different.Age,disability level,residence status,regional factors are most common and prominent.On the one hand,for all ages,disability level,living status needs analysis,this paper found that demand level difference between groups,the groups of high age,serious incompetent,older adults living alone showed the highest degree of dependence.Furthermore,the demand level,dissatisfaction index and satisfaction index are different between groups.On the other hand,according to the analysis of "dependency" and "expectancy" between regions,this paper found that the dependency level of Shanghai is significantly higher than other regions,the expectancy level of Shanghai and Kaifeng are higher than Changsha and Yinchuan,and the differences between Changsha and Yinchuan are not significant.In view of above phenomena,this paper discussed the differences of dependence and expectation between the regionals from two aspects: service development level and the service habit of the elderly,the social resources are great substitute for community services.Fourthly,insufficient service provision is a major problem between service strategy and actual situation.First of all,according to the results of analysis,this paper analyzed how to identify demand objects,how to input service resources and how to provide services from theoretical perspective.Then,this article found out the lack of ability to provide services restricts the priority of service provision.Finally,this paper found out the lack of policy orientation,the deviation of government function and the ambiguity of the responsibility between multiple subjects result in the lack of capacity of service supplying.Fifthly,the effective satisfaction of the elderly's service demand should be based on two perspectives: the established conditions and the future development.In the short term,it is suitable to strengthen the combination of formal and informal services, implementing dynamic demand assessment and menu service mode,and promoting the combination of daily living care services and medical care services.In the long run,improving service supply capacity is the most critical way to ensure the satisfaction.Therefore,it is necessary to optimize the function of government,improve the personnel training mechanism,and strengthen the ability to integrate community resources,to ensure the orderliness of multiple participation,the continuity of service delivery and accessibility of service acquisition.The innovation of this study is that it divided the demand into need and want based on the understanding of the demand of the community home-based care service of elderly.Moreover,this paper analyzed the dependence and expectation tendency of the elderly for the different services with attractive quality theory and its Kano's model,the priority satisfaction strategies for service demand was also discussed.Therefore,this paper extends and enriches the perspectives and ideas of related research,and it has important academic value and practical significance for the research and the development of community home-based care services.