The Evaluation And Simulation Of Home And Community-based Services Policy

Facing with the increasingly severe aging situation,our government suggests to comprehensively build a solution of diversified old-age care service system for the aged basing with the home-based care,depends on the community-based,supported by the institution and covered the urban and rural areas.Since the implementation of home-based care by the community,each city has adopted a variety of service delivery methods based on the characteristics of every city to explore an efficient way with low-cost and sustainable urban community-based home care service mode,in order to adapt to the needs of community-based and home-based care service in each city and do the prepare for the increasingly severe pension situation for the future.Because our country is entering the aging society before getting rich,the community-based home care pension market is just starting in our country,and the community home-based environment is not mature,so our government is in the leading position in the community home-based environment,bearing the responsibility of cultivating the community home-based market and integrating all resources to provide services for the community home-based market.The government of our country communicates the arrangement of work of the community home-based care to all participants through the community home-based pension policy.The correctness of the community home-based policy directly affects the development of the community home-based business.Therefore,it is necessary to make a detailed study for the policy of the community home-based home care.At present,the research on community home-based home care focuses on the demand and supply,service mode,government function,designing public policy and so on,and lacks of comprehensive and systematic analysis and evaluation of community home-based policy.Based on it,the study analyzes the community home-based home care policy firstly from the level of national,provincial and municipal.Secondly,evaluates the whole process of the community home-based policy(policy formulation,policy evaluation,policy performance).Finally,studies the mechanism and simulation of the community home-based policy on the policy target.The specific research is carried out according to the following steps:The research results of this paper are summarized as follows:(1)The framework construction of home-based policy in urban communities.First of all,gathering the policy documents related to home-based old-age care in urban communities at the levels of national,provincial and municipal,and using the content analysis method to extract the theme framework on the policy.The obtained keyword of the thematic framework include: vision statement,principles and values,standards for successful implementation,funding policy,community home-based old-age care service facilities policy,talent public-service policy,standardization policy,promotion and incentive policy,evaluation policy,regulatory policy,support for policy implementation,and link up with other policies.Based on it,the vertical policy analysis framework of policy level and policy content is established.It includes the national macro policies and contents,provincial mesoscale policies and contents,municipal micro policies and contents.The city level micro policy establishes a horizontal policy analysis framework of three dimensions: activity subject,policy tool and activity stage,and divides the content of the city level community home-based policy according to the above three dimensions.Finally,the paper elaborates the content of the home-based policy of urban community at the national level,provincial level and municipal level.Through the analysis,we have a deep understanding of the current situation of the community home-based policy,which lays the foundation for the post study.(2)Assessment of home-based care policies in urban communitiesBased on the systematic literature analysis of the theory to policy evaluation framework,the evaluation index system of urban community home-based care policy is preliminary constructed.Based on it,the above index system is revised by Delphi method,concluded the three first-class evaluation indexes,nine second-class evaluation indexes and 36 third-class evaluation indexes.The reliability and validity of the evaluation index system are analyzed.Cronbach's value of the internal consistency test of the evaluation index system is greater than 0.7;the content validity is pretty good;the correlation between the overall evaluation index and each secondary evaluation index are greater than 0.7,which has a good structural validity.Taking ANP analysis method to determine the weight of urban community home-based policy evaluation index system,and take an empirical study of home-based policy to Nanjing community.(3)A study on the mechanism of home-based policy in urban communities.This chapter first uses the sociallearning theory,the three-stage theory of attitude change and formation,the cognitive learning theory and the planned behavior theory to determine the influencing factors of urban community home-based care service use behavior,constructs the conceptual model of service using-behavior factors and policy intervention path analysis,and puts forward the hypothesis system of this study.Through the questionnaire survey to measure the factors of the above conceptual model,the structural equation model is used to verify the hypothesis system.Through this part of the research for the follow-up simulation to lay a theoretical foundation.(4)The simulation model for the urban community home-based policy based on system dynamics.According to the general steps of modeling application of system dynamics: identifying problems,determining system boundary,determining causality,establishing system dynamics model and optimizing resources.Firstly,determined the boundary of the system and the condition hypothesis of the model.Next,constructed the causality of the service use of community home-based elderly care,and analyzed the feedback loop.Based on the above system boundary and system assumption,and on the basic requirements of system dynamics modeling and the current situation of community home-based care service,drawing the system flow chart.According to the results of simulation,it is found that the attention coefficient and initial enhancement rate of various policy interventions have an important impact on the optimization of using behavior.In the process of practical optimizing,we should pay equal attention to the specific intervention measures of publicity policy and incentive policy,and promote the implementation of the home-based care service strategy in urban communities by many multiple measures.In addition,increasing the initial enhancement rate of policy interventions can enhance the rate of the increasing in using behavior.However,it will increase the input cost of relevant government departments in policy,so the initial enhancement rate of each policy intervention should be set reasonably according to the target using behavior and target cost of the local government departments.