Rethinking The Home And Community-based Elderly Care Services Under The New Situation Of "Depending On The Old"

As the aging population continues to deepen,the total and proportion of the elderly population continues to rise,while the proportion of the working-age population has continued to decline for 8 years.The old-age dependency ratio has continued to rise and has shown an accelerating trend.China is under the new situation of "depending on the old".Cost and emotion are the most important considerations for older groups when choosing an ageing approach.Retirement in the home and community allows them to stay in the familiar living environment and social network,while enjoying professional services,and the cost is lower than the institutional pension.So it’s the first choice of the elderly and families.However,in this new situation,the home and community-based elderly care services must better adapt to the dual characteristics of China’s social and economic development and demographic changes,and increase the effective supply of old-age services to meet the large-scale and increasing number of elderly people with multi-level and diversified aged care services.The effective supply of aged care services is the core of home and community-based elderly care.Based on the theories and practice at home and abroad,this paper firstly analyzes the current situation of the supply of home and community-based elderly care services from perspectives of the relevant policies,construction of community institutions and facilities for the elderly,and service personnel.The result shows that the policy environment is becoming better ang better,the institutions and facilities for the elderly improves gradually,and the scale of personnel training is constantly expanded,service supply has a certain development.In addition,this paper summarizes four modes of the provision of home and community-based elderly care services:government sponsorship,hierarchical linkage mode;government-led,intermediary organization operation mode;government subsidy,agency sponsorship,chain operation mode;government purchase service,enterprise contraction,market operation mode.Through the typical case study and comparative analysis,we know that the government must deepen reforms to streamline administration,delegate powers,and improve regulation and services,fully open the elderly care market and form a benign pattern of cooperation among government,market and society.It’s the only way to develop home and community-based elderly care.Based on the above analysis,combined with China’s actual national conditions and specific practices,it is found that the most prominent problem in home and community-based elderly care services is that service supply and demand are not suitable,which is manifested by insufficient supply and imbalance of supply and demand structure.Based on the analysis of the contradiction between supply and demand,the reasons are as follows:(1)Service provider level:the multi-supply system has not yet formed,the demand information is incomplete,and the service personnel are not professionally specialized;(2)the service recipient level:insufficient effective demand,The supply information is incompletely controlled;(3)The supporting system level:the evaluation and supervision system is not perfect,and the volunteer legislation and incentive system are lacking.Studying the practice of community care in developed countries represented by the United Kingdom,the United States,and Japan to help the home and community-based elderly care to better adapt to China.Then,proposing the following policy recommendations to better meet the needs of the aged care services and perfect the social welfare system:strengthen the system construction;optimize the old-age service supply mechanism;establish a pension service team combining professional talents and volunteers;create a home community pension Internet information platform to promote the informationization and convenience.