Research On Risk Assessment Of Government Purchase Of Home Care Service

Under the background of the aggravating trend of aging population and the increasing demand of homebased care,purchase of home care service as a manifestation of innovation in government performance shows the government's concern for elderly welfare service,especially those who are in difficulties.Since the implement of government purchase of home care service is still in its infancy,supporting measures such as institution guarantee and market mechanism haven't been fully established,leaving relatively large degrees of freedom in various operational aspects and significant uncertainties in implementation results.Although the purchase of home care service satisfies the needs of some elderly people to a certain extent,whether the maximization of economic and social benefits has been achieved from the perspective of input and output remains to be judged.In order to fully understand and grasp the risk status of government purchase of home care service and to improve the efficiency and implement results,following research work has mainly been done in this study:First of all,the research progress of risk on government purchase of home care service is clarified by review and summarization of domestic and foreign literature.Then the deficiencies of existing research and the necessity of this study is demonstrated.An overall introduction of research framework is elaborated as well.On the basis of policy analysis and literature analysis,the concept of government purchase of home care service and the risk of government purchase of home care service are defined to lay the foundation for follow-up research.Besides,it introduces the basic theories of new public management,principal agent,risk management and limited rationality which are related to this research.Then the cause of risk on government purchase of home care service is analyzed from a theoretical perspective and the inevitability of the existence of risks is discussed.Secondly,,the policy evolution of government purchasing of home care service is discussed through the analysis of related policy documents,and specific implementation measures for purchasing home care services in some areas are introduced from the perspectives of service targets and purchasing standards.Then it compares the three typical purchasing modes and specifically describes the operation status of home care service purchasing in Nanjing from the aspects of fund-raising,service supervision and so on.A summary of the common problems in current purchase practice is given and has laid a solid foundation for subsequent research on risk identification and risk assessment.Thirdly,the characteristics of the risk on government purchase of home care service are analyzed,and 23 risk factors are identified with the method of literature analysis and interviews on stakeholders considering the characteristics.In order to deepen the understanding and awareness of the risk on purchasing home care services and to facilitate the implement of risk assessment,factor analysis method is used to extract several common factors on the basis of risk identification results.Common factors such as government capacity risk and purchase content risk are used as first-level evaluation indexes to construct a risk assessment index system.Finally,the method of extension matter-element is chosen to establish an assessing model of risk on government purchase of home care service,and occurrence probability,loss rate and difficulty of processing are taken as the feature set of risk factors.Then the evaluation mentality and specific evaluation process are explained in detail for further use.At last,the risk assessment model is used to quantitatively evaluate the risk level of government purchase of home care service in Yuhuatai District.A comparative analysis finds that the results of the assessing model are in line with the actual situation,which verifies the availability and practical significance of the assessing model.On the basis of assessing results,risk response measures are put forward from the five dimensions of government ability,service ability,purchase process,purchase content and service supervision,which provide feasible suggestions for improving the efficiency and implementation results of government purchase of home care services.