Research On The Service Delivery Mechanism Of Long-term Care From The Perspective Of Self-organization And Participation

In recent years,the aging of the population has been intensified.With the prolonged life expectancy,the frequent occurrence of chronic diseases in the elderly,the "miniaturization" of the family structure and the gradual weakening of its self-service function,the demand for nursing care services in the elderly has become stronger and stronger.As one of the 15 national pilot cities for long-term care insurance,Chengdu has initially demonstrated its effectiveness.As of the end of 2019,it had paid a total of 360,400 people with a total of 443 million yuan,which has positive demonstration significance.Taking Chengdu as the starting point,this paper studies the operating mechanism and realistic dilemmas of long-term care service delivery at this stage,and constructs a long-term care service delivery mechanism based on self-organization.First,based on Neil Gilbert’s social policy analysis framework,this article analyzes the operating mechanism of long-term care service delivery from a holistic perspective,focusing on the four elements of funding sources,distribution content,provision strategies,and quality control.Secondly,this article combines the practice of long-term care in Chengdu and classic cases in the process of long-term insurance service delivery to analyze the current dilemma of care service delivery.Finally,in order to solve the problems in the delivery of long-term care services,this paper uses the governance advantages of self-organization in the delivery of long-term care services,and builds a long-term care service delivery mechanism based on self-organization.The research content of this article is divided into six chapters: The first chapter elaborates the background and significance of the research on long-term care service delivery,and combs and reviews the relevant literature on the delivery mechanism of long-term care services at home and abroad,the reality dilemma of care services,and self-organized governance.Comment;The second chapter defines the core concepts of this article,and provides the theoretical basis of this article from the origin and development of the theory,the main content of the theory,and the specific application of the theory in this article.Neil Gilbert’s The social policy analysis framework,self-organizing governance and new public management theories are described;the third chapter conducts a general analysis of the operating mechanism of long-term care service delivery.According to the different sources of funding,this article divides the delivery model of long-term care services into family care,community mutual assistance and institutional care.Based on Neil Gilbert’s social policy analysis framework,this article focuses on funding sources,allocation basis,provision strategies,and quality.Controlling these four dimensions analyzes the operating mechanism of long-term care service delivery under different modes;the fourth chapter starts from the practice of long-term care in Chengdu and analyzes the three long-term care service delivery modes of family care,community mutual assistance and institutional care.Realistic dilemma and its causes.Through analysis,it is found that there are widespread human resource shortages,single service content,lack of professional care,and difficulty in quality control in the delivery of long-term care services.The fifth chapter analyzes the classic cases of long-term care insurance service delivery in Chengdu,combined with case analysis.The current status and existing problems of care service delivery at this stage lay the foundation for the construction of a long-term care service delivery mechanism.The case study found that the new home care services of social support institutions in Chengdu can better meet the diversified care needs of the disabled elderly,but the social support institutions are seriously understaffed,and the establishment of a long-term care mechanism involving multiple parties is imminent;Sixth;This chapter is based on the self-organization of the long-term care service delivery mechanism.This article starts from a holistic perspective,based on Neil Gilbert’s social policy analysis framework,combined with the practical experience of long-term care service delivery in Chengdu,focusing on fundraising,service content,delivery methods,quality control,self-organizing cost sharing and other elements Construct a long-term care service delivery mechanism with self-organization participation,and use self-organized governance advantages to solve the governance dilemma of long-term care service delivery.This paper uses qualitative research methods and semi-structured interview methods to participate in the practice of long-term care service delivery,observes the status quo of long-term care service delivery in Chengdu,and analyzes the operating mechanism of different long-term care service delivery modes by induction and retrospective methods.And the real dilemma.Studies have found that there are widespread human resource shortages and lack of professional care in the delivery of long-term care services.At the same time,the content of care services is single and the lack of attention to the mental life of disabled elderly people makes current care services far from satisfying the disabled elderly.Need for care.The study found that using the governance advantages of self-organization in the delivery of long-term care services and introducing self-organization into the operating mechanism of long-term care service delivery can give full play to the active role of the government,families and communities,and voluntary organizations,and improve the supply and supply of care services.Quality,reduce the cost of care service delivery.This paper constructs a long-term care service delivery mechanism under self-organization participation around fundraising,service content,delivery methods,quality control,self-organization cost sharing and other factors.By constructing a multi-participant long-term care mechanism,it can meet the diversity of disabled elderly people.Chemistry needs for care.