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The psychological health problems of the disabled elderly in China are closely related to physical diseases. Through combing the opening of psychological care services in the pilot cities of long-term care insurance in China, it is revealed that the current pilot cities do not pay much attention to psychological nursing services, the evaluation of psychological nursing needs is absent, and the implementation regulations of psychological nursing services are not perfect. Pilot cities should strengthen psychological care services for the disabled elderly; develop an evaluation system compatible with psychological care services; improve and implement psychological care services; developing information systems that match the needs of psychological care services to ensure the linkage of data in the transition between long-term care and medical needs; and the clients and service providers should cooperate to jointly promote the sustainable development of long-term care insurance psychological care services.
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Objective:To explore the elements of the diversified caring bank based on long-term care insurance system to provide a basis for the construction of diversified caring bank framework system.Methods:The phenomenological research method was adopted to conduct semi-structured interviews with 15 nursing management personnel in pension institutions in Suzhou and Suzhou long-term care insurance policy implementation management personnel in March to May 2021. NVivo 11 was used to manage interview data, and applied Colaizzi 7-step analysis to conduct inductive analysis and extract the themes.Results:The elements of the diversified caring bank based on long-term care insurance system were divided into three main modules: diversified caring personnel, diversified caring content and diversified incentive measures. The diversified caring personnel module included full-time and part-time caring personnel. Diversified caring content included six elements: daily life assistance, professional life caring, professional medical caring, communication and emotional support, emergency caring and special disease caring. Diversified incentive measures module included two elements: labor currency and "benefit" care currency.Conclusions:The diversified caring personnel provides continuous power for disabled caring; diversified caring content provides ways to meet the various needs of the disabled elderly; diverse incentives are effective ways to attract and stabilize the caring workforce.
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Under the background that the family doctor teams undertake the evaluation function of long-term care insurance for the elderlies living at home, it is imperative to further improve the efficiency of its integrated aging-medical care by strengthening the management. The Huacao community health service center and Hongqiao community health service center in Minhang District of Shanghai explored the construction of a family doctor′s home-based aging care management path, a practice launched since February 2021. This path was mainly designed with the entry criteria, management requirements for various services and evaluation indicators, with a service path form formulated on such basis. The form covered three stages: that before the on-site service, that on the day of the on-site service and that after the on-site service. Each stage was subdivided into three dimensions: the work content of the main aging-medical care, the key works of family doctors and the key works of assistant nurses. The implementation of this management path can enable such teams to provide further refined, standardized and procedural aging-medical care services, avoid service delays, improve service quality and management efficiency, and improve the utilization efficiency of health resources.
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Objective:To investigate the status and influencing factors of quality of life among disabled elderly whose home care services were paid by the long-term care insurance in Guangzhou, in order to provide a scientific evidence for improving their quality of life and improving the long term care insurance system.Methods:A convenience sample of 161 disabled elderly whose home care services were paid by the long-term care insurance were recruited and investigated. A cross-sectional survey was conducted by general information questionnaire, World Health Organization Quality of Life Brief Scale, Barthel Index, Self-rating Depression Scale, Self-rating Anxiety Scale and World Health Organization Happiness Index Scale.Results:The score of the quality of life among disabled elderly was 41.17±7.79. And the score of its four dimensions in descending order: environment, social relationships, psychological and physical with (11.38 ± 2.71), (10.36 ± 3.16), (9.86 ± 2.08), (9.56 ± 1.89) points. The multiple linear regression analysis found that frequencies of outdoor activities per week, frequencies of hospitalization in the past year, subjective well-being, depression and anxiety influenced the quality of life of the disabled elderly( P<0.05). Conclusions:The quality of life of disabled elderly is not optimistic. Nurses in home care institutions should formulate personalized nursing intervention based on influencing factors to improve the quality of life of disabled elderly, while providing a basis for optimizing long-term care insurance policies.
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Objective:To sort out the assistive device social security policy of Japan. Methods:The assistive devices social security policy for the older adults and the disabled in Japan was summarized in term of four dimensions: who, what, how to deliver and how to fund. Results:Japanese assistive device social security policy covered most of disabled groups according to the legal protections, delivering a variety of assistive devices products and services. Meanwhile, it has tried to avoid over expenditure through ways of lump-sum control, unit price and quantity control, users self-pay and strict evaluation system. For the service delivery system, the evaluators were strictly neutral, while the providers were in market. The funding came from user-payments, public finance and insurances, etc. Conclusion:Japan has established a mature social security policy system and service system for assistive devices, which can be used as a reference for China.
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Introduction The purpose of this study was to reveal the current conditions of the nursing care system for elderly and determine the problems concerning the cross-culture care practice. Methods This study is a qualitative and descriptive research. We conducted a semistrustured interview study including six foreign sresidents in Okinawa who provided consent to participate in the study. After recording verbatim and extracting the contents related to elderly nursing care, We coded these contents into each semantic unit to extract the themes by repeating the reorganization/integration while considering the similarity of the contents. Results We extracted 126 codes as a narration related to nursing care and generated. 61 subcategories and 17 categories. Next,we extracted the following nine themes: 1） struggles overcoming the language barrier. 2） anxieties over symptom control or treatment of their illnesses. 3） a financial burden for receiving satisfactory medical treatment. 4） a sense of security with someone who understands their language, 5） affection by overcoming language barriers. 6） a cross-cultural environment in which they can choose their own living condition, 7） a sense of appreciation for care services that assist in achieving life stability. 8） adaptation to the cross-cultural life and attachment to Okinawa,and 9） life supported by religion, and the method of burial according to religion.Conclusion The prpbrems should be resolved through 1） care service restructuring with the involvement of the recipients. 2） utilizing their community where they can share cultural connection, 3） fostering an interculture environment, 4） supporting caregivers, and 5） supporting an ideal end-of-life care with religion.
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The Japan-Korea Primary Care Exchange Programme, which is an international project held by the Japan Primary Care Association and Korean Academy of Family Medicine, provides young family physicians opportunities to visit annual conferences and training programs each year. This article reports the history and several topics that Japanese delegates in 2018 learned about in Korea regarding family medicine: "Outpatient Department" "Health Information Systems" "Healthcare System for the Rapidly Aging Population," and "The Current Situation and Issues in Long-term Care Insurance."
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Objective@#To develop the outcome evaluation index system for home care service of disabled elderly based on the long-term care insurance in Guangzhou.@*Methods@#Delphi method was used to develop the outcome evaluation index system for home care service of disabled elderly under the long-term care insurance in Guangzhou. The Analytic Hierarchy Process was used to determine the weights of all indexes.@*Results@#After two rounds of expert consultation, questionnaire response rates were 86.67%, 100%; expert authority coefficients were 0.843, 0.858; coefficients of variation ranged from 0.07 to 0.23 and 0.00 to 0.14; coordination coefficients ranged from 0.221 to 0.355 and 0.379 to 0.433 (P<0.01). The final index system consisted of 5 first-level indicators, 17 second-level indicators, and 59 third-level indicators. The analytic hierarchy process was used to determine the weights of all indexes, and the consistency test (CR<0.1) was performed.@*Conclusions@#The outcome evaluation index system for home care service of disabled elderly under the long-term care insurance in Guangzhou was scientific and reliable, the weights of all indexes were reasonable, which could provide reference for the designated service institution on evaluation and improvement of the effect of home care service of long-term care insurance for disabled elderly.
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BACKGROUND: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. METHODS: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. RESULTS: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). CONCLUSION: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.
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Humans , Caregivers , Food Services , Health Expenditures , Insurance , Insurance, Long-Term Care , Japan , Korea , Long-Term Care , Nutritionists , Quality of LifeABSTRACT
Japan is the only country that has implemented a nation-wide measure for functional disability leading to long-term care needs in old ages. Thus, there are no previous national trials that we can refer to. Whether its disability prevention measure succeeds or not will depend on our own efforts toward the future. In this paper, I will overview a 10-year experience with the disability prevention program launched in 2006, and then will point out the relevant issues in realizing the prevention of functional disability in old ages for exercise and sports scientists.
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OBJECTIVES: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. METHODS: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ○○. For analysis, semi-structured questionnaires that required about 20–30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. RESULTS: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. CONCLUSIONS: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.
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Aged , Humans , Cross-Sectional Studies , Dental Hygienists , Insurance, Long-Term Care , Long-Term Care , Oral HygieneABSTRACT
This article attempts to compare the similarities and differences of the two typical models of the com-mercial insurance institutions participating in the long-term health care insurance from the perspective of public-pri-vate partnership and the prospect of its application. By the comparison of the long-term health care insurance opera-tion model in multiple pilot areas,this paper selects Haidian district and Qingdao city as typical representative mod-els. The commercial insurance institutions in the two models are introduced by the urban government bidding and en-trusted a corresponding institution to supervise. However,the degree of participation of commercial insurance institu-tions in the Haidian district model is deeper than that in the Qingdao city model,and in the aspects of profit and loss, the Haidian district model is better than the Qingdao city model. The Qingdao city model of commercial insurance in-stitutions bears more risks of profit and loss. From the point of view of the application prospects of the two models, the Haidian district model is suitable for the promotion of large cities with large population, industrialized economy and high management level,while the Qingdao city model is more suitable for cities with smaller population, higher risk and weak supervisory power of commercial insurance institutions.
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Objective: To explore the influencing factors of the long-term care insurance demand in Jiangsu province and provide reference for the establishment and improvement of a perfect long-term care insurance system in China. Methods:Factor analysis,multiple regression analysis and logistic regression analysis were applied for analy-zing the survey data collected from Jiangsu province. Results: (1) From the perspective of subjective attitude fac-tors,nursing expenses,family ability to pay,insurance concepts, nursing needs and chronic disease awareness and long-term care insurance demand are positively correlated,and the impact was significant;(2) From the perspective of demographic factors, residents with a high level of education are more willing to buy long-term care insurance. Conclusions: The Chinese government should take full account of the influencing factors of long-term care insurance demand,improve the income of urban and rural residents,increase promotional activities,and encourage nursing in-stitutions to develop at different levels,and build a government-led long-term care service system.
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The Chinese society is becoming predominantly an aging society, as the number of elderly people increase very quickly. The long-term care insurance for the elderly is becoming more and more important. Therefore, analyzing the factors affecting the demand of long-term care insurance has important theoretical and practical signifi-cance for the Chinese society. This paper uses the grey correlation model and the generalized grey relational model method,using 2005-2015 nationwide data,and divides the main factors influencing the demand of long-term care insurance into economic and non-economic factors. The main influencing factors on demand for long-term care insur-ance were analyzed by the grey relational analysis which shows that the impact of social insurance expenditure on long-term care insurance is the most important economic factor. The per capita education level of non-economic fac-tors and the elderly dependency ratio were rated to be the most important non-economic factors. According to the em-pirical results,combined with China's national conditions and actual situation,it provides a new research method and ideas for the long-term development of the nursing insurance.
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Objective:To establish index weight system of the disability rating scale for the long-term care in-surance. Methods:On the basis of the index system of disability rating scale constructed by Delphi method,the im-portance of each index of the scale was evaluated and its weight was calculated by analytic hierarchy process. Re-sults:The weights of the 4 first-class indicators in the long-term care insurance disability rating scale were as follows:sensory perception was 0.2408,basic activities of daily living was 0.5899,cognitive ability was 0.1204, emotional& behavior was 0.0489;and the weights of 22 second-class indicators were calculated simultaneously. Conclusions:The determination of the index weight further improves the system of disability rating system,and provides reference for the development of long-term care insurance system.
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This paper attempts to review the long-term care insurance policies which have been issued in 13 national pilot cities such as Qingdao and Haidian district,Beijing. The paper investigates the problems and challen-ges China's long-term care insurance system faces with,and put forward the construction of long-term care insurance system. The preliminary thinking on some issues, such as the relationship between welfare and marketization when the long-term care insurance has been put into practice on a trial basis,the relationship between long-term care insur-ance and medical insurance,and the specific implementation plan of the long-term insurance. According to the issued documents issued by pilot regions,it was found that there are not only differences but also similarities among the pilot cities in who are insured,who pays the insurance fee,what might be covered,what the levels of insurance are,and what kind of service will be provided. Although the long term care insurance system has been initially established in these cities, the specific implementation remains to be demonstrated, e. g. supervision and management, nursing service provision. In addition,local governments need to continuously expand the benefit range of long-term care in-surance to ensure long-term success,do good coordination and connection of long-term care insurance and pension in-surance,and reasonably allocate the medical insurance,pension,and health care resources.
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Because of societal aging, Japanese pharmacists have an increasingly important role in home medical care. This is particularly true because more pharmacists are required to perform physical assessments to optimize patient treatment. However, few investigations have examined whether patients understand the role of pharmacists and the importance of home medical care. In this study, a questionnaire was provided to 260 patients aged 20-90 years to determine patients’ attitudes toward home medical care and pharmaceutical interventions. After conducting factor analysis, items related to home medical care were excluded at the stage of exploratory factor analysis, indicating that patients are not interested in home medical care. However, regarding pharmaceutical interventions, the questionnaire revealed that 42% of the patients required the pharmacists to provide information regarding the prescribed drugs during home medical care visits. Furthermore, it was demonstrated that 85% of the patients were unaware that physical assessments are also perform by pharmacists. In contrast, >50% of the patients believed that pharmacists had an important role in physical assessment interventions.
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Objectives This study investigated the use of In-home services of the Public Long-Term Care (LTC) Insurance System by foreign residents in Osaka city to serve this population better.Methods Using information from the WAMNET database, questionnaires were sent to 1,800 care managers (CMs) affiliated with 1,106 In-home Care Support Office and Community General Support Centers in Osaka city (1-4 CMs/site), and collected between February and early March 2011. The data collected were analyzed quantitatively, focusing on descriptive statistics. And fisher’s exact tests were used to evaluate the relationship between the Japanese communication skills and age, sex, and family structure.Results We obtained answers from 460 CMs (collection rate 25.6%). The total number of foreign residents covered under the service by CMs was 590, and we analyzed the valid data of 312 foreign user’s information. Home-Visit LTC and Day Care for LTC were most frequently used. 34.3% of CMs had difficulty communicating in Japanese, there was a higher proportion of people who had difficulty in communication with older age group (p<0.05), and noticed that nearly 60% faced economic hardship. Conclusion Our results suggest that careful communication is required with older age groups. This indicates that there may be difficulties in communication and understanding the clients’ needs, which are necessary to create care plan and to ensure optimal utilization of the services. And it is possible to reduce the service required user charge due to the insufficient economic status. The support system should be strengthened to address communication and economic difficulties faced by foreign users of In-home services, from the standpoint of the service fairness.
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Background: We investigated how individual home care services by nurses, care workers, and therapists at patients' homes are related with the continuation of home medical care service provided by medical doctors.Methods: This research retrospectively analyzed primary insured patients registered with the Japanese long-term care insurance system who had newly started using home medical care service, and whose care level was between 1 and 5 according to national long-term care insurance system claims data. We performed multivariable logistic regression analysis to evaluate patients who used home medical care continuously for >3 months and the utilization of each home care service adjusted for patient age, gender, and care level.Results: A total of 26,590 patients were analyzed. Multivariable analysis revealed that the following home care services were associated with longer continuation of home medical care service compared with home medical care alone: day service (OR, 2.10; 95% CI, 1.98-2.23), home help service (1.91; 1.81-2.01), day care including rehabilitation (1.88; 1.69-2.10), home-visit rehabilitation (1.49; 1.31-1.69), and home-visit nursing (1.23; 1.16-1.31).Conclusions: Our results demonstrated a correlation between utilization of home care services and longer continuation of home medical care from the start. These findings may help medical doctors who provide home medical care service collaborate with other home care services by nurses, care workers, and in-home care therapists.
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Through the comparison of the long-term care insurance financing mode,financing channels,responsibility sharing and financing level of Germany,Japan and Korea,it is found that the three countries' financing policies fit the national conditions and institutional traditions and realize multi-channel independent financing.The responsibility to raise funds to the parties to a reasonable share,cash is now pay financing model is also difficult to cope with the challenges of the aging population.In recent years,China has carried out long-term care insurance practice,from the financing mode,financing channels,responsibility sharing and financing level to share the four dimensions of China's 13 areas of long-term care insurance financing comparative analysis and found that for China's long-term care insurance financing there are many Controversy.The future of China's long-term care insurance financing also need to be improved from many aspects.