Survey on the Demand for Elderly Care Services of Community Residents in Beijing and Analysis of Influencing Factors

Objective: To investigate the current situation of the demand for geriatric care services of community residents in Beijing and analyze the influencing factors to provide a reference basis for meeting the demand for diversified and professional geriatric care services. Methods: A self-made questionnaire was used to randomly survey 1558 elderly individuals at community health service centers in 8 urban districts where elderly care centers were planned to be built. The influencing factors of the different characteristics of elderly care service needs from three aspects were analyzed using a dichotomous logistic regression model: predisposing, enabling, and, need factors. Results: 69.7% of the elderly required home care services, 22.8% wanted to get care services at elderly care centers, 15.9% wanted to get care services at nursing homes, 12.3% required community care services, and 7.4% didn’t know where to access care services. 68.5% of the elderly required care services for disabilities/semi-disabilities, 58.0% for dementia, 54.7% for common diseases, 34.9% for rehabilitation training, 33.0% for plumbing care, and 7.5% for hospice care. At the same time, there were urban- rural differences in the demand for elderly care services, with suburban elderly having a higher demand for care services than those living in urban areas (P < 0.05). The elderly’s demand for care services was mainly related to age, place of residence, and gender in the causative factors, mode of residence and physical condition among able factors, and mode of care services and care needs among need factors (P < 0.05). Conclusion: The demand for elderly care services was differentiated by factors including place of residence, age, and gender. It is crucial to accurately match the demand for elderly care services, innovate the mode of elderly care services, and improve the service quality to improve the elderly health service system.

Improvement of the Legal System for Addressing the Issue of Elderly Care in China in the Context of Population Aging

Rapid population aging is a social reality facing China at present,and the issue of elderly care has become a hot topic of social concern.Legislation to address the issue of elderly care in the context of population aging should follow systematic concepts to achieve“vertical and horizontal integration.”In terms of content,it is necessary to formulate specific legal approaches around“the elderly and children,”with a focus on guaranteeing the livelihood and protection of the rights of the elderly while taking into account childbirth,employment and other issues.the laws should not only safeguard the social participation and labor rights of the elderly,but also effectively respond to the social challenges brought about by the aging of the population.It is also necessary to optimize the family planning policy to ease the burden of child-raising,improve the population structure and promote the long-term balanced development of the population,thus fundamentally solving the problem of population aging.the effort to improve the legal system to deal with the issue of elderly care in the context of population aging will better advance Chinese modernization.

Problems and Countermeasures of Intelligent Elderly Care Service in the Context of Fewer Children in China

With the intensification of population aging and the implementation of the three-child policy,the elderly care pressure of Chinese families continues to rise.Therefore,accelerating the construction of a new intelligent elderly care service model is an important measure to actively respond to population aging,ease the burden of family elderly care and promote high-quality economic development.In view of this,this study analyzed the intelligent elderly care service to explore the relevant countermeasures of the intelligent elderly care service in the context of fewer children.

Reform and Reconstruction of the Rural Elderly Care Service System in the New Era

With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the rural elderly care service system.However,the current service system based on welfare-multiplex and urban community environment is often difficult to operate in the rural areas of central and western China.And the urban home care service for the aged is inappropriate to the rural reality;community service for the aged faces difficulties in practice;institution care for the aged develops slowly;the synergy among different elderly care service models is poor.Through observing the rural areas of central and western China in the field for a long time,this paper proposes to build the rural elderly care service system based on family supporting,supported by community mutual assistance care,supplemented by institution care for the aged,combined with medical care,and localized with diversified forms for targeted groups according to different realities.And the system should follow the fundamental guidance of development-oriented family policy,adhere to the governance mode of multiple subjects with one core and respect rural reality,which could provide a feasible way for the reform and reconstruction of the rural elderly care service system.

Dilemma and Path for Rural Mutual Aid Elderly Care Model in Underdeveloped Areas——A Case Study of Dazhou City in Sichuan Province

Rural mutual aid elderly care,as an emerging elderly care model,has become an exploration and attempt to rebuild rural communities in the process of rural social transformation.At present,in the vast underdeveloped rural areas,the rural mutual aid elderly care model is faced with such problems as imperfect policies and regulations,insufficient funds,single service items,lack of professional services,and limited functions of civil organizations.It is necessary to strengthen the formulation and improvement of laws and regulations,and to ensure the stable source of funds,enhance the level of specialization,and give full play to the functions of social organizations in the rural mutual aid elderly care model,so as to promote the sustainable development of the rural mutual aid elderly care model.

Childcare,Elderly Caring and Off-farm Employment of Rural Couples in China

Based on the representative sample survey data of more than 1 000 farmers in 101 villages of 25 counties of 5 provinces in China,within the framework of family collective decision-making,this paper studied the effects and heterogeneity of childcare and elderly caring on the off-farm employment mode of rural couples. It found that caring the children younger than 3 years old significantly reduces the possibility of offfarm employment of rural couples;conversely,if there is 60-80 years old member in the family,it will significantly increase the possibility of off-farm employment of rural couples or the wives. Caring the children above 12 years old or the elderly older than 80 years old reduces the possibility of off-farm employment of the husbands. Whether there is preschool education service facility in the village has no effect on the off-farm employment of the couples.

Exploration on China's Institution-oriented Elderly Care Service System Based on Human Factors Engineering

Objective Aging process in China has brought more and more challenges to traditional home-based care for the aged and more attentions to the mode of institution-oriented elderly care.This work,by analyzing the problems and defects of institution engaging in elderly care based on the human factors engineering theory,discusses the people-centered institution-oriented elderly care service system,in terms of the problems that the pattern of institution-oriented elderly care focuses more on the facilities and environment construction than the principal role of people in the elderly care service system.Methods Sampled the institutions engaging in elderly care in Hefei City,Anhui Province,P.R.China(a medium-sized city in China);surveyed 45 institutions engaging in elderly care and 828 registered elders in Hefei City by hierarchical and systematic sampling method.Results(1)institutions engaging in elderly care shared the occupancy rate of 49.6%and low total service efficiency;(2)institutions engaging in elderly care offered 100%life-oriented service items,but only 6.1%personalized service items provided;(3)100%simple housing facilities in elderly care institutions,but extremely less personalized service facility(3.2%),with poorer quality and less satisfaction;(4)insufficient professional service staff could be available;48.1%institutions have 5 or less professional service staffs.Conclusion A countermeasure to improve the elderly care service system was raised here by aiming at improving the institution-oriented elderly care service:(1)to transfer service toward the people-oriented concept,formulating preferential policy for endowment insurance;(2)to pay attention to personalized design of service facility,offer personalized and featured service items,and improve service management level;(3)to build professional team for elderly care.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

差序整合:农村互助养老实现的机制分析

农村互助养老作为居家养老和机构养老的重要补充,是解决农村深度老龄化问题的有效路径。基于差序格局理论,在“关系—制度”分析框架和“差序整合”概念下,通过对河南省W县农村互助养老实践的考察发现,当地基层党组织成功借助乡土社会关系的差序规则,有序动员老人的亲友、邻里、同乡等为其提供养老服务。究其实现机制,具体包括以重塑认知为重点的制度嵌入、以均衡互利为核心的关系整合、以满足需求为关键的行动激励、以责任践履为要求的多方问责机制,差序整合为农村互助养老的可持续发展提供了规引制度、关系基础、参与动力和履责保障,实现了社会关系、制度规约、行动主体的全面整合,推动了农村养老服务高质量发展。

农村养老的模式选择与影响因素研究

老龄化已成为全球共同面临的难题,而中国步入老龄化的速度不断加快,农村养老的解决方案更是迫在眉睫。基于河南省洛阳市孟津区4镇6村202份调查问卷,采用二元Logistic回归模型,从基本特征、经济特征、心理特征、社会支持特征4个维度15个指标构建农村养老模式选择模型。研究表明:基本特征中,受教育程度、性别、年龄、婚姻、居住情况、子女个数、家庭收入来源、月收入和稳定性对养老模式选择有一定影响;心理特征中担心无人照顾会对机构养老和互助养老产生影响;社会支持特征中社会养老保险补贴满意度会对社区居家养老产生影响。在家庭养老模式中,性别、年龄会对模式选择产生显著的正向影响,受教育程度、居住情况则产生显著的负向影响。在机构养老模式中,性别、年龄、受教育程度、婚姻、家庭收入来源、家庭月收入对模式选择有显著的正向影响,而害怕被遗弃和对社会养老保险补贴满意度有显著的负向影响。在社区养老模式中,受教育程度、居住情况、子女个数、日托、担心无人照顾以及对社会养老保险补贴满意度对模式的选择有显著的正向影响,而家庭收入来源、年龄和收入来源的稳定性则有显著的负向影响。在互助养老模式中,性别、婚姻、居住情况、担心无人照顾具有显著的正向影响,社会养老保险补贴满意度具有显著的负向影响。

社会支持网络推动农村养老高质量发展的对策研究

随着农村老龄化加剧,农村老龄人口数量激增。但由于经济发展水平相对较低、医疗资源有限、精神慰藉缺失、应急保障不足等原因,农村养老面临着巨大的挑战。解决农村养老存在的问题,有利于保障广大农村老年人的基本生活权益,关系到农村的繁荣稳定和乡村振兴。因此,必须结合农村实际充分发挥政府、社区、家庭等社会支持主体的作用,建立完善的社会支持网络,改善老年人生活质量,提升其幸福感。

北京市医药分开、医耗联动综合改革前后老年人群医疗机构治疗费用流向研究

目的通过研究北京市医药分开、医耗联动综合改革前后老年人群医疗机构治疗费用流向变化,为优化老年患者就诊流向提供数据参考。方法采用多阶段分层整群抽样方法获取样本,基于《卫生费用核算体系2011》核算老年人群的治疗费用。结果2016—2019年北京市老年人群医疗机构治疗费用由604.57亿元增长至797.54亿元,年均增速为6.83%,其中社区卫生服务中心治疗费用增长最快,增速达24.04%,治疗费用占比由11.31%增长至17.71%,三级医院治疗费用占比下降4.39个百分点。门诊患者治疗费用流向优化明显,低龄老年门诊患者更愿意在社区就诊,但高龄老年患者门诊流向优化更明显。内分泌、营养和代谢疾病,神经系统疾病等慢性病老年门诊患者治疗费用大幅度流向社区卫生服务中心。结论改革对不同年龄和疾病的老年患者就诊影响不同,建议加强基层医疗卫生机构服务能力建设,凸显二级医院发展特色,精准完善老年患者分级诊疗体系。

乡村振兴战略背景下农村养老模式及养老问题的破解路径

农村养老问题是重要的民生工程。我国农村老年人的劳动能力下降、身体机能弱化、情感交流匮乏,农村养老面临着传统家庭代际赡养功能日渐衰退、机构养老服务推广速度缓慢、公共服务水平相对滞后等问题,探索互助养老与机构养老有效融合、建立以“医养结合”为核心的农村养老服务模式、构建灵活多样的农村“精神”养老模式等有助于满足农村老年人日益增长的多样化养老需求,全面提升农村的养老服务质量。

长期护理保险与农村老年群体消费扩容提质效应分析

目的:分析长期护理保险(长护险)试点对农村老年群体消费的扩容提质效应。方法:基于CHARLS四期调查面板数据,运用双重差分模型实证检验长护险对农村老年群体消费的影响。结果:长护险主要通过降低暂时性收入波动和随机性健康支出的不确定性,对农村老年群体消费产生扩容提质效应,且在多元筹资模式、失能家庭和老龄化程度较高地区的扩容提升效应更为明显。结论:长护险试点对农村老年群体消费具有显著的扩容提质效应,应持续扩大长护险试点和待遇覆盖范围,加强社商合作,制定差异化长护险制度,充分满足农村老年群体的消费需求。

农村养老模式的创新与启示——以H省“妇老乡亲”互助养老模式为例

随着农村老龄化程度加剧,探索既具有中国特色、又能满足我国农村老年人养老需求的创新性养老模式,成为发展农村养老服务的重要任务。H省创新的“妇老乡亲”互助养老模式,利用外部专业力量为本土组织和人员提供管理和服务培训,同时吸引本土和外部的多方力量加入,为农村养老可持续发展培育“造血”能力和组织能力,实现服务对象的生活质量改善和服务主体的共同成长。这一特色养老服务模式对乡村振兴战略背景下发展我国农村养老具有启示意义:协同发展农村养老服务,需要从资金的可持续性,本土人力资源的开发,基层自治组织的培育,社会力量的介入和服务的精准化、差异化及规范化等多方面共同发力。

县域视角下公共养老服务体系的现状、问题及优化路径

为积极应对人口老龄化,国家正逐步推进县乡村三级养老服务体系的建设。通过对中部3省9县养老现状的调研,认为在当前县乡村三级养老服务体系建设过程中存在重城市理念、轻农村要素,重供给侧、轻需求侧,重机构建设、轻经营管理,重指标化、轻在地化等问题。据此提出根据中部县域财政情况,满足不同养老群体的差异化需求;赋予县级政府政策空间,正确定位县乡村功能;充分认识农村养老优势,动员社会力量参与;构建县域养老三级联动的组织形式等建议,从而推动县乡村三级养老服务体系的发展,提升农村养老服务供给的质量和水平。

乡村振兴战略背景下遂宁市本土化农村医养结合养老体系优化研究

随着乡村振兴战略的深入实施和农村老龄化问题的日益严重,农村医养结合养老服务成为新的研究领域。本文以遂宁市为例,分析了农村医养结合养老服务的发展现状和面临的问题,提出了优化路径和措施。研究认为:政府应发挥主导作用,完善政策支持;加强医护专业人才队伍建设;利用“互联网+”进行多学科诊疗,推动数字信息化建设;转变传统思想观念,主动了解农村医养结合养老服务。这些措施有助于推动农村医养结合养老服务的可持续发展,为解决农村老龄化问题提供有效途径。

农村康养产业发展的理论阐释、多元实践与政策协同

农村康养产业作为一种新兴业态,是秉承新发展理念,在乡村舒适性资源利用、后生产主义乡村价值兴起、农村产业融合驱动、城乡地域共同体功能再造、康养政策引领与市场开发的共同作用下发展起来的。在实践中,通过对自然资源、文化资源、中医药资源和森林资源的开发,与乡村旅游、文化体验、休闲度假、景观游赏等相融合,发展出田园康养、文化康养、医疗康养和森林康养等新型形态,在一定程度上满足了老年群体多样化的养老需求,建立了互益性城乡交流渠道,推动了乡村产业振兴和社区建设。但目前其发展的体制机制尚不成熟,存在统筹规划力度不足、业态短板比较突出、专业康养人才匮乏、数字化技术融入较低等问题。文章建议从主体、资本、人才、技术的角度构建政策协同的路径,加强顶层设计、突出康养特色、创新职业培训、推进科技创新,实现农村康养产业的可持续和高质量发展。同时,围绕农村康养产业发展,还应加强对城乡互益性养老服务机制的研究,探讨建立衔接有序、功能互补的城乡养老服务网络的可能路径。

积极应对农村人口老龄化的互助养老:实践状况、核心经验与社会效益——基于一个中部乡镇的田野调查

在农村人口老龄化形势日益严峻而传统家庭养老功能萎缩的背景下,探索符合农村实际的社会化养老模式是积极应对农村人口老龄化的必然要求。基于一个乡镇11年互助养老的田野调查发现,互助养老本质上是立足于村社共同体的农村社区养老模式。以老年人为主体的多层次动员、以公共意志为准则的民主化管理、以熟人社会为基础的社会嵌入,以及以互助组织为中介的资源链接构成互助养老持续运作的核心经验。相较于机构养老和行政主导的社区养老模式,互助养老能够产生显著的社会效益,不仅可以满足老年群体的多元养老需求,也能取得一定的社会治理成效。积极应对人口老龄化视角下,当前政府应结合乡村振兴战略的实施,为发展农村互助养老创造有利的政策环境与资源条件,逐步推广互助养老模式。

乡村振兴背景下农村旅居康养的发展逻辑、限制与展望

农村退休迁移一度是西方多学科重点关注的研究话题,其兴起主要源自乡村生活价值重估、消费功能兴起以及老年人提高晚年生活质量的要求,但在国内学术界一直缺乏相应关注。伴随中国进入到城市化高速发展、乡村全面振兴的新发展阶段,珠三角、长三角等一些地方已开始出现与国外退休迁移相似的农村旅居康养动向。结合实地调查发现,相较于西方农村退休迁移的发展背景,国内农村旅居康养的产生是市场开发、政策引导、乡村建设和个体诉求共同作用的结果。鉴于国内农村旅居康养还存在全年段康养开发不足、医疗卫生基础薄弱、配套服务设施不完善、专业服务水平不高等问题,建议围绕城乡养老服务需求形成整合性框架,促进康养与旅游融合发展,引导乡村舒适驱动型发展,开展城乡互益性养老交流,建立城乡养老服务联合体,以实现城乡共建共享共富。