Analysis of home care-based multi-level old-age service system

With the deepening of China＇s aging, China＇s social pension problem more obvious each day, and gradually become the focus of attention of the whole society. On the one hand, China entered the aging society, old-age needs to grow exponentially. The sixth national census shows that in our country, the population aged 60 and 13.26% of the total population over the total number of 179 million, 65 years and older the proportion of 8.87% of the total population, the absolute number of nearly 120 million. Hundreds of millions of older age groups will produce a growing demand for care services, which is the original old-age service system and the whole economic and social development is a huge pressure. On the other hand, with the economic and social transformation, the traditional model of family pension has been unable to adapt to the profound changes in modem employment, family structure, the concept of retirement, since most parts of China, ＂old before getting ricE＂ the situation, how to solve the elderly the pension problem is related to the overall situation of China＇s economic and social development, related to the overall situation of building a harmonious society in China. Under current national conditions, the emphasis on the development of a single individual body to meet the growing demand for pension service is not realistic, we must mobilize the enthusiasm of all aspects of the element, multi-service integration of resources subject to their commitment to a different responsibilities and tasks provide a full range of care services according to different types, different levels of the actual needs of the older age groups. On the aging problem is that the whole community to face, you need to multi-government body, families, communities, institutions combine effectively starting from the actual needs of the elderly population, according to the financial assistance, life care, spiritual consolation three set the specific needs of services, through a government-led, home-based care services, community care services for the core and supplementary services for institutions focused on pension and other means to provide a full range of pension services.

The Experience and Enlightenment of the Development of Old-age Care Services in Russia

Through the analysis of the history and current situation of Russia＇s old-age care services system, this paper analyzes and studies the old-age care services system in Russia. By means of law and social policy, Russia can promote the active participation of the elderly in politics, economy, culture and other activities to promote the positive image of the elderly. The active aging policy in Russia and the development trend of the old-age care service to promote the social adaptation and re-employment of the elderly are of positive significance to the development of our country＇s old-age care service.

The research of the community-home elderly long-term care service system

With the rapid development of the aging of the population, the demand of long-term care services in the elderly is growing. Because of family miniaturization, core, and currently limited social accumulation are difficult to meet the demand of the elderly in long-term care.Community provides the elderly long-term care services, and provides the elderly all kinds of household helping services. They just make up for the inadequacy of the family and society.And how to make the community elderly long-term care services become more suitable for the needs of the elderly at home, provide better service for the elderly, are our current problems to be solved.

Users’ Perception and Satisfaction of Current Situation of Home Health Care Services in Jordan

Background: The healthcare system in Jordan is evolving and has to continuously respond to the changing risk profile of the population. The purpose of this study was to examine perception of users and providers of the quality of home health care services. Methods: A descriptive design was used to collect data from a convenience sample of 82 users of home health care services. Results: Users had low to fair satisfaction (30.5% - 69.5%) about the quality of care provided, had moderate satisfaction (72.0% to 81.7%) about the information received, and had low to fair satisfaction about education related to goal of treatment and medication (46.4% - 53.3%). Users had high level of agreement (>70%) that health agencies provided interpersonal care. Conclusion: The ability of the frail people to choose from a variety of cost-effective long-term care services is limited.

Changes and Development of Home and Community Based Elderly Care Service Policies in China

This paper analyzes the current situation of the development of home and community based elderly care service in China,points out the existing problems,and puts forward improvement measures,aiming to deepen the understanding of HCBS and promote the theoretical research and practice of community home-based elderly care service.

The Study of Supply and Demand about Shanghai Community Home Care Service

As the Chinese traditional culture is depend on the family, community home care service is increasingly becoming the first choice of the elderly aged. At present, Shanghai is facing serious aging phenomenon, the contradiction between supply and demand has become more and more intensified. This paper will analyze the status of supply and demand about Shanghai community endowment services, and then identify the existing problems and reasons for the accordance in supply and demand on the base of analysis. Ultimately, this paper will raise suggestions about promoting the matching between supply and demand of Shanghai community home care service.

The home healthcare nursing services provided to the elderly patients: a systematic review

Background:Home healthcare(HHC)services entail quality and transitional care offered to patients.Doctors recommend HHC to the elderly patients to manage conditions and improve outcomes outside inpatient setting.The systematic review aimed to assess the home health care nurse services to elderly patients.The question of this study is“what are the home nursing care services provided to the elderly patient.Methods:A systematic review methodology was adopted.A search was conducted on PubMed,MEDLINE,and ScienceDirect using keywords such as“home healthcare”,“nurse services”,“home nurses”,“elderly patients”.The search generated 1829 articles,but 16 were selected for qualitative synthesis for meeting the eligibility criteria.Joana Briggs Institute’s critical appraisal tools helped in the assessment of the primary studies.A data extraction matrix generated themes,while a narrative synthesis presented the studies.Results:The review found administration of HHC nursing services in different settings.The studies confirmed varied nature of HHC,types of HHC services,transitional care,challenges,or barriers of offering HHC,relationships,and decision-making process in offering care to the patients and family.The studies presented HHC as a multifaceted component with diverse impact on the patients and family.The analysis revealed that HHC nurses services served elderly persons as the main target group.HHC faces different challenges,barriers,or obstacles such as work,role conflict,organization,elderly patients,and decision-making.Conclusion and Future Research:The assessment of the HHC nursing services provided to the elderly patients reveals different facets of the healthcare process that reduce readmissions and hospital costs.Further studies could explore the provision of care to other target groups such as middle-aged patients to understand the impact of the services.

A family nurse-led intervention for reducing health services’utilization in individuals with chronic diseases:The ADVICE pilot study

Objectives:Intensive health services'utilization is common in older individuals affected by chronic diseases.This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services'use(readmissions and/or emergency service access)among older people affected by chronic conditions.Methods:This is a non-randomized before-after pilot study.A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months.Standard home care was provided during the first four months'period(months 1-4),followed by the educational intervention until the end of the study(months 5-8).The intervention,based on the teach-back method,consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment,potential complications,medication adherence,and health behaviours.Rates of health services'use were collected immediately before(T0),and after the interventions(T1).Differences in utilization rates were examined by the McNemar's test.Potential factors associated with the risk of health services'use were explored with a Cox proportional hazard regression model.Results:The sample(n=78)was predominantly female(n=50,64.1%),and had a mean age of 76.2(SD=4.8)years.Diabetes mellitus was the most frequent disease(n=27,34.6%).McNemar's test indicated a significant reduction in health services'use at T1(McNemar χ^(2)==28.03,P<0.001).Cox regressions indicated that time and patient education,as well as their interaction,were the only variables positively associated with the probability of health services'use.Conclusion:A teach-back intervention led by a family nurse practitioner has the potential to reduce health services'use in older patients with chronic diseases.

A Multi-Objective Scheduling and Routing Problem for Home Health Care Services via Brain Storm Optimization

At present,home health care(HHC)has been accepted as an effective method for handling the healthcare problems of the elderly.The HHC scheduling and routing problem(HHCSRP)attracts wide concentration from academia and industrial communities.This work proposes an HHCSRP considering several care centers,where a group of customers(i.e.,patients and the elderly)require being assigned to care centers.Then,various kinds of services are provided by caregivers for customers in different regions.By considering the skill matching,customers’appointment time,and caregivers’workload balancing,this article formulates an optimization model with multiple objectives to achieve minimal service cost and minimal delay cost.To handle it,we then introduce a brain storm optimization method with particular multi-objective search mechanisms(MOBSO)via combining with the features of the investigated HHCSRP.Moreover,we perform experiments to test the effectiveness of the designed method.Via comparing the MOBSO with two excellent optimizers,the results confirm that the developed method has significant superiority in addressing the considered HHCSRP.

Orientation Program on the Care of Children Tracheostomized in the Home Environment

Objective: The aim of the study was to make a literature review on counseling and family education about the care with tracheostomy and develop a guidance booklet for parents about the cautions in handling tracheostomy tubes at home. Methods: This research is based on literature review from 1992 to 2012, realized from October of 2011 to August 2012, through the following databases: medline, lilacs, scielo and sibinet USP, with the elaboration of a guidance booklet for parents, about home care of tracheostomized children. Results: We elaborated a guidance booklet for parents, about the care of tracheostomized children and all were described according to literature review. Conclusion: According to the literature review family education in the care of tracheostomized children is essential so that caregivers have full autonomy to safely and effectively conduct the necessary techniques in their homes.

Study on Supply and Demand of Intelligent Home-based Aged Care in Shanghai

The 21st century is an era of aging population. With the accelerated aging of the population in our country, and the grim form of population aging, intelligent home-based care has become a concern for the elderly in the area of ？？care. This paper starts from the new concept of intelligent home-based care services and defines intelligent home care services. It also summarizes the current theoretical researches related to domestic research, which is of great significance for the investigation and research conducted in the later stage of research.

居家养老慢性病患者智慧医疗服务需求研究

目的探讨居家养老慢性病患者智慧医疗服务需求,并分析需求实现与用户满意度之间的关系。方法采用招募法选择长春市299例居家养老慢性病患者为研究对象,采用混合研究方法,通过一般资料调查、半结构式访谈了解居家养老慢性病患者自我管理现状及健康服务需求,运用卡诺模型进行需求分类和优先级排序,最后结合产品服务系统的设计方法,构建产品和服务一起交付的智慧医疗产品新模式。结果需求指标3、4、9归属为必备型需求,需求指标1、5、8归属为期望型需求,需求指标7、10、11、13、14归属为魅力型需求,需求指标2、6、12、15归属为无差异型需求。结论居家养老慢性病患者智慧医疗服务应在维持和完善必备、期望属性需求基础上,发展和创新魅力属性需求,客观分析和改良无差异需求,以提升居家养老慢性病患者智慧医疗产品用户体验和服务质量。

中国老年人口健康状况及其家庭照料需求预测

中国人口老龄化快速发展,失能、半失能老年人口规模迅速扩大,老年照料需求快速增加。科学预测不同失能状况老年人口规模及其照料服务需求是推动老年照护服务体系建设的重要基础。文章基于中国老年健康影响因素跟踪调查(CLHLS)数据,使用Markov模型测算中国分性别、分年龄段老年人口健康状况转移矩阵,运用队列要素预测法、多元回归法等预测得到2020—2035年中国不同失能状况老年人口规模及其照料服务人员需求规模、家庭照料经济成本。预测结果显示:中国失能老年人口规模呈现增长态势,从2020年的1946万人增至2035年的3424万人,失能老年人口的比例从2020年的7.4%小幅增至2035年的7.9%,且中重度失能老年人口增幅更快,2035年时轻度失能老年人口规模相比2020年增加66%,中重度失能老年人口规模相比2020年增加92%。女性失能老年人口规模增速快于男性,80岁及以上老年人口失能比例增长更快,2035年男性70~79岁、80~89岁、90+岁三个年龄组失能老年人口规模分别为2020年的1.53倍、1.92倍、1.94倍;2035年女性三个年龄组失能老年人口规模分别为2020年的1.72倍、2.29倍、2.52倍。老年家庭照料需求将呈现快速增长态势,家庭照料服务人员需求量从2020年的2795万人增至2035年的4863万人,增长74%。2020—2035年健康老年人口的照料服务人员需求量占总需求量的比例在57%左右,中重度失能老年人口需求量占比在24%左右,轻度失能老年人口需求量占比在19%左右。60~69岁老年人口所需的照料服务人员占比最高,90岁及以上年龄组对照料服务人员的需求量增长更快。老年人口家庭照料经济成本从2020年的3027亿元增至2035年的11676亿元,将增长近3倍。中重度失能老年人口所需的家庭照料现金成本相比2020年增长3.1倍,轻度失能老年人口所需的家庭照料现金成本相比2020年增长2.6倍。男性老年人口所需家庭照料现金成本低于女性老年人口,且增速也低于女性老年人口。本研究基于定量预测结果提出积极推进健康老龄化,加大促进生育的政策支持力度,尽快推广长期照护保险制度,以赋能家庭为着力点加强失能老年人口的支持体系建设,大力发展老年护理服务业,大力发展养老护理职业教育等政策建议。

中国社区嵌入式养老:现状与问题浅析

为实现全体老年人享有基本养老服务的目标,社区嵌入式是未来中国养老服务发展的重点方向。社区嵌入式养老是指通过下沉与整合各类服务资源,在社区内打造集居家、社区、机构服务为一体的养老综合体,以实现在家中或家门口就近就便享受优质养老服务的一种新型养老模式。基于嵌入性的理论视角,研究从需求嵌入、资源嵌入、主体嵌入与理念嵌入四个维度构建了中国社区嵌入式养老的制度框架,并对当前社区嵌入式养老的服务项目、服务设施及运营模式进行了系统归纳。研究发现中国社区嵌入式养老发展面临着多维度的嵌入问题,这集中表现为:供需关系存在错位,缺乏有效链接机制;专业服务人才有限,服务品质良莠不齐;权责利益交织纵横,多方主体协同困难;地区基础存在差异,经验范式推广受阻等。基于此,建议政府、社区、企业及社会组织等应进一步明晰主体职责定位,结合地区特点,依托有利资源,合力推动社区嵌入式养老实现高质量发展。

人工智能赋能的居家社区养老服务发展及其生态系统优化策略研究

伴随人工智能技术在养老领域的应用,居家社区养老服务呈现协同演化的发展趋势。这既为人口老龄化下破解养老服务供给不足难题带来重大机遇,也给传统居家养老服务模式转型升级提出新的挑战。基于人工智能的技术特征,从“技术创新—要素整合—系统优化”过程维度揭示人工智能赋能的居家养老服务发展路径,并以生态系统理论为分析框架,从“宏观—中观—微观”层面剖析人工智能赋能居家社区养老服务面临规范性与引领性政策缺位、参与主体协作网络不紧密、养老服务供给和需求结构性失衡三个障碍。据此,应从宏观层面完善配套政策,加大对人工智能养老服务的支持力度;从中观层面推进数据汇聚与整合,促进多主体协同联动;从微观层面精准识别老年人需求,提升养老服务供给效率与能力。

居家社区医养结合服务利用及满意度现状研究

目的 了解居家社区医养结合服务的利用情况和满意度现状,提出促进医养结合发展的对策和建议。方法 通过目的抽样法于2023年5-7月在我国东、中、西部分别选取无锡市、长沙市、成都市对2 125名60岁及以上正在接受或曾接受过服务的老年人进行问卷调查。采用描述性分析、卡方检验、单因素方差分析、多元线性回归等统计学方法对有效问卷数据进行分析。结果 不同地区的就医习惯、服务方式、常用药的获取情况差异具有统计学意义(P<0.05)。服务总体满意度均值为(4.32±0.625)分,处于“满意”与“非常满意”之间。线性回归结果显示,失能程度、慢性病患病情况、地区差异、就医习惯、服务方式、常用药获取情况、地理可及性情况是服务满意度的影响因素(P<0.05)。结论 老年人所接受的居家社区医养结合服务对于基层医疗卫生机构利用情况较好,服务总体满意度较高,但存在地区之间发展不平衡的问题。应进一步以基层医疗卫生机构为重点发展居家社区医养结合服务,完善医保支付机制,加快建立健全长护险制度,不断提高居家社区老年人的满意度和居家社区医养结合服务质量。

社区居家养老服务设施的智能化研究

文章首先分析了社区居家养老服务模式运作目标,然后阐述社区居家养老服务发展现状,最后围绕强化政府支持、完善智能化软件与硬件、优化服务内容,对社区居家养老服务设施智能化建设措施进行科学探讨。

基于SFIC模型的养老事业与养老产业协同发展路径研究

养老事业与养老产业同属于养老服务体系的组成部分,充分发挥其作用重在二者协同发展,即二者相互协作实现养老服务的充分供给且达到二者共同发展的双赢效果。通过创新性地将SFIC模型用于养老服务体系发展分析,构建养老事业与养老产业协同发展分析框架,从星光老年之家、公建民营养老机构、政府购买养老服务、长期护理保险制度试点四个案例比较剖析养老事业与养老产业协同的起始条件、助成性领导、制度设计、合作程序,提出改善养老事业与养老产业协同发展的起始条件、发挥助成性领导对养老事业与养老产业协同发展的创造性作用、优化养老事业与养老产业协同发展的制度设计、在养老事业与养老产业协同发展中实现良性合作四个养老事业与养老产业协同发展的路径。

三级医院老年患者出院延续护理转介单的设计及应用

目的设计三级医院老年患者出院延续护理转介单,评价其应用效果。方法参考文献资料,采用焦点小组讨论法,设计老年患者出院延续护理转介单,嵌入医院电子病历信息系统,病区护士使用转介单对有延续护理需求的患者进行转介,延续护理服务部专职护士接收转介,到病区为患者提供出院计划服务及出院后上门护理。结果2021-2022年全院21个老年患者所在科室均应用老年患者出院延续护理转介单实施转介,转介患者386例,其中80岁及以上老年患者219例(56.7%),内科系统9个科室共转介患者267例(69.2%)。为386例患者出院后1个月内提供上门护理服务597例次,患者出院30 d内非计划性再入院率为5.2%。结论设计及应用老年患者出院延续护理转介单,有利于促进转介及提高不同部门工作人员之间合作协调性,从而满足出院老年患者延续护理服务需求及降低出院后非计划性再入院率。

肝母细胞瘤患儿围术期及术后居家营养干预方案构建及临床应用

目的构建肝母细胞瘤患儿围术期及术后居家营养干预方案,并对其临床应用效果进行评估。方法采用半结构式访谈、文献研究法和德尔菲法构建肝母细胞瘤患儿围术期及术后营养干预方案。选取2019年1月—2021年8月我院手术的31例肝母细胞瘤患儿作为对照组,2021年9月—2023年12月手术的31例肝母细胞瘤患儿作为试验组,对照组采用常规诊疗护理,试验组在对照组基础上实施营养干预方案。通过比较不同干预措施下两组患儿术前1周、术后1周、术后1月、术后3月的营养状况和血生化(血清白蛋白、血清前白蛋白、血液血红蛋白)指标,以及身高、体质量和体质量指数,评估营养干预方案临床指导意义与实际效果。结果术后1、3月时,与对照组比较,试验组患儿轻中度和重度营养不良人数明显减少(Z=-2.799、-3.697,P<0.05),血清白蛋白、血液血红蛋白水平显著升高(F=4.870~111.680,P<0.05);术后1、3月与术前1周比较,两组患儿血清前白蛋白和血液血红蛋白均显著升高(F=60.247~1270.148,P<0.05);试验组术后1、3月时的体质量变化(与术前1周比较)显著高于对照组(Z=-2.405、-4.716,P<0.05)。结论成功构建了肝母细胞瘤患儿围手术期及术后居家营养干预方案,研究发现干预方案可改善患儿营养状况、血生化指标及体格发育情况,具有较好的科学性和实用性。