Research On Implementation Effect And Influencing Factors Of National Standard Basic Standard For Senior Care Organization

Object:In order to provide theoretical support and practical reference for further pilot work,implementation of pension service standards and promotion of standard construction experience,and constantly optimizes service level for senior care by evaluating the effectiveness of the implementation and analyzing the problems and experience gained in pilot units of the “Basic Standard for Senior Care Organization”(GB/T29353-2012).Methods:(1)The questionnaire about “Survey on the Satisfaction of Elderly People in the Standardization of Pilot Units” was designed based on the “Basic Standard for Senior Care Organization”(GB/T29353-2012)and relevant literatures,which included 11 basic conditions and 4 satisfaction dimensions,there are 36 items in 4 satisfaction dimensions(2)Using cluster sampling,49 pilot units in 12 provinces(cities)were selected.Random sampling was used in each pilot unit to investigate 759 elderly people;Random sampling was used to select 11 managers and 10 nursing staff for interviews;6 staff members from upper management departments were selected to conduct interviews by adopting convenient sampling(3)Frequency,percentage,mean,standard deviation,t-test and one-way ANOVA were used to process survey results;(4)TOPSIS was used to rank organizations;expert consultation was used to determine the TOPSIS weight;(5)Induction and summary were used to organize interview data.Results:(1)759 elderly people were surveyed.Women,Han nationality,widowed,highly educated,and senior citizens were the main types.(2)Through the survey,it is found that the highest standardized score of satisfaction is the life care dimension,the lowest is the dimension of medical service before the implementation of the standard,the highest is the dimension of environmental equipment,and the lowest is the dimension of health care service after implementation,and the satisfaction degree of all dimensions is improved,the degree of environmental equipment is(48.81±5.23vs50.43±5.02,t=6.316,P<0.01),life care is(62.42±6.61vs63.70±6.74,t=3.804,P<0.01),health care services is(30.91±3.65vs31.43±3.57,t=2.878,P=0.004),entertainment services is(13.29±1.61vs13.59±1.56,t=3.850,P<0.01),but in specific service,increased scores for pressure sore prevention,personalized meals,consultation service,mental support services,and entertainment services were not statistically significant(P>0.05).(3)Institutional nature is the influence factor affecting the satisfaction of entertainment services,age is the influence factor affecting the satisfaction of life care,health care services,and entertainment services,and life care,medical service,and entertainment decreases and then increases.Seniors' ability levels is the influence factor affecting the satisfaction of environmental equipment,life care,and health care services,with the degree of human disability increased,satisfaction with environmental equipment and medical services increased first and then decreased,with life care services increased.Education background is the influence factor affecting the satisfaction of life care and health care services,seniors with illiteracy are most satisfied with life care services and health care services.Occupations is the influence factor affecting the satisfaction of four dimensions,the senior citizens of individual industrial and commercial households have the highest satisfaction score in all 4 dimensions.(4)After interviews,it is found that “attention from the leadership”,“employee awareness”,“lack of talent”,“execution strength”,“theoretical research”,“mental service”,“combination of medical and support” "standard quality," and "standard system,",etc.,are factors that influence the effectiveness of the implementation.(5)The self-assessment results of the “Basic Standards for the Senior Care Organization” show that the main problems are the lack or incompleteness of the institutional system and the barrier-free facilities symbols need to be improved.(6)The TOPSIS method ranked 49 pilot units.After the third-trimester,the public pension institutions in the first 16 pilot units were more than private(9:7).Combined with the self-test materials submitted by the pilot units,it was found that the factors affecting the implementation of the standard are similar to those of the interview.Conclusions:(1)The Basic Standard for Senior Care Organization has achieved good results in pilot units,but there are still weak links in the transformation of some facilities and equipment,provision of personalized dietary services,mental support services and health care provision services.(2)Ages,educational background,ability levels,occupations and different kinds of institutions have different effects on the satisfaction status of the elderly,it suggests that pilot units should provide services according to the different characteristics of the elderly.(3)The implementation effect of the “Standard” is affected by many factors including the insufficient degree of attention of some local leaders,the lack of awareness of staff,the lack of talents,the failure to continuously implement,the lack of operability and practicality of the standard itself,and so.In order to further promote implementation of the standard,it should further enhance the awareness and standardization consciousness of the managers and nursing staff,make up for the short board of talents,increase the supply of funds,establish a standard system and evaluate the effect mechanism of normalization.