政府购买居家养老服务监管:基于博弈视角的研究

本文针对居家养老服务行业制度缺失、运营效率低下等现实问题,从政府与机构二元的行为出发,构建了政府购买居家养老服务的监管博弈模型,探讨了政府与机构在服务过程中的动机与策略,揭示了我国居家养老行业发展的内在机理.结论显示:在居家养老行业发展初期,政府在提供政策激励的同时,必须加大对参与机构的监管力度,以保证服务质量,促进行业的可持续发展.     

中国城市地区机构养老服务业发展分析

机构养老是社会养老服务体系中的重要内容。其中,针对失能老年人的护理型养老机构发挥了主要作用。本文分析我国老年人入住养老机构的意愿,2000²010年间中国老年人愿意入住养老机构的比例有所下降,但其中失能老年人愿意入住养老机构的比例明显上升。这对护理机构建设的专业性、护理性提出了更高要求。本文预测我国城市地区护理型养老机构的市场发展空间,20152010年间中国老年人愿意入住养老机构的比例有所下降,但其中失能老年人愿意入住养老机构的比例明显上升。这对护理机构建设的专业性、护理性提出了更高要求。本文预测我国城市地区护理型养老机构的市场发展空间,2015²050年,我国失能老年所需床位数和护理人员数都将大大增加。针对我国养老机构发展中存在的问题提出相关建议。     

高龄老人入住养老机构意愿的影响因素研究——以重庆市主城九区为例

高龄老人入住养老机构的意愿主要受个人特征、家庭特征和对养老机构认知等因素的影响,通过对重庆市主城九区实地调研,采用Logistic二元回归模型进行分析。结果表明居住地、年龄、家庭规模、家庭年净收入、设施完善程度、服务质量好坏等因素对高龄老人入住养老机构的意愿影响显著。在此基础上提出应重视农村地区机构养老模式发展、加快养老机构建设等建议。     

我国养老机构的现状研究

随着老年人口数量上的增加以及养老观念的逐步变化,社会上也在大力发展着各类养老机构。利用相关的政策法规文献和现有的统计资料分析政府对养老机构的建立和管理的规定、我国养老机构数量和区域分布的特点以及现有机构的利用程度。1999年的《社会福利机构管理暂行办法》对养老机构的发展具有指导和推动性意义。1989年以来养老机构的床位数在增加,收养的老年人始终占养老机构床位的70%左右。入住农村养老机构的老年人多于城市养老机构收养的老年人,农村每千名老年人所拥有的床位数也高于城镇的数量。导致城乡差异的原因有待于进一步调查和分析。如何提高现有养老机构的利用程度是我们需要认真考虑的问题。     

村落视野下的农民机构养老意愿研究——基于鄂、川、赣三省抽样调查的实证分析

本文基于对鄂、川、赣三省34个村庄农民的问卷调查数据,运用定序Logistic回归模型,分析了村庄因素尤其是宗族对于农村居民入住养老机构意愿的影响。研究发现:虽然现阶段机构养老成为了部分农村居民的养老选择,但总体来看,多数农民入住养老机构的意愿较低。村庄的宗族结构和功能在一定程度上影响农村居民入住养老机构的意愿。有非正式宗族网络的农村居民比没有宗族网络的农村居民入住养老机构的意愿低,有正式宗族组织的农村居民入住意愿最低。宗族在公共服务中的功能越强,农村居民入住养老机构的意愿越低。同时,家庭在村庄中的经济社会地位处于非下层的农村居民比处于下层的农村居民入住意愿更低。     

高度老龄化地区养老服务探索及发展策略研究--以天津市为例

人口老龄化加剧、社会经济发展转型与政府职能转变成为大力推动养老服务发展的客观要求。天津市已成为我国高度老龄化地区之一，在政府主导下初步形成了以社区居家养老和机构养老为主干的养老服务体系。但养老服务建设缺乏详细规划且管理机制尚未健全、养老服务事业的经费投入难以满足现实需求、区域间的养老服务资源非均等性明显、民办养老机构发展困难、专业养老护理人员缺乏等问题逐渐显现。未来时期应完善制度顶层设计和明确政府养老服务财政责任、促进养老服务管理标准化和加强行业监管、构建公办与民办养老机构差异化发展格局、促进养老服务人员的多元化与专业化、探索建立老年护理保险制度，从而推动养老服务健康发展。     

中国老年人口的健康状况、福利需求与前景

利用中国2005年1%人口抽样调查资料对老年人口身体健康状况进行分析,并利用联合国人口预测资料,对2050年以前的中国老年人口身体健康状况及其对养老机构床位数需求进行预测。结果表明,2005年中国老年人口中"不能正常工作或生活不能自理"者占15.02%,规模达2 169万人。不同性别、年龄与城乡的老年人口的身体健康状况之间存在明显的差异,人口老龄化与家庭养老功能急剧弱化使得未来中国需要入住养老机构的老年人数量急剧增加。     

高龄失能老人居住方式及影响因素的实证研究

高龄失能老人居住方式直接影响到长期照护服务质量，通过对211位高龄失能老人的调查，发现他们理想的居住方式与现实的居住方式之间存在很大差异，大多数高龄失能老人理想的居住方式是与家人同住，而现实的居住方式则是入住养老机构比例在大幅度提高。经济与社会支持因素对高龄失能老人理想居住方式有较大影响，而居住地、婚姻状况、儿女数量等多因素阻碍他们实现理想的居住方式，使他们不得不居住在养老机构。在研究的基础上，提出社区应整合社会多方资源将照护服务递送到居家高龄失能老人身边，同时提高机构照护服务质量，使身居养老机构的高龄失能老人在接受专业化照护服务的同时感受到居家的温馨，以实现高龄失能老人理想的居住方式，满足他们对长期照护服务的需求。     

社区居家养老服务质量模型研究——以上海市为例

文章在对上海市社区居家养老服务定性分析基础上,根据服务质量模型和理论,尝试构建社区居家养老服务的质量模型。研究结果表明,社区居家养老服务质量模型是一个包括助洁、助餐、助医和康乐服务质量4个子维度的二阶结构,现阶段科学合理地评估社区居家养老服务质量,应该从助洁、助餐、助医和康乐服务质量方面进行操作。应用该模型对上海市社区居家养老服务质量评价的结果表明,上海社区居家养老服务已经步入规范发展的轨道,基本实现了服务能力、服务执行的稳定性与一致性,具备了可靠性、响应性和可感知性等特点,但在通过个性化服务和专业人员队伍反映的移情性和保证性方面还存在一定的差距。     

中国老年人口的养老意愿及其城乡差异——基于中国老年社会追踪调查数据的分析

老年人的养老意愿是建立养老服务体系必须考虑的重要方面.文章根据中国人民大学2014年"中国老年社会追踪调查"数据,分析我国老年人的养老意愿及其影响因素.采用多分类Logit回归模型比较城市和农村老年人的居住意愿.分析发现城市老年人的居住意愿受个体、家庭、社区三类因素的共同影响,呈现多元化特点,而对农村老年人居住意愿有显著影响的因素则基本集中于家庭因素.结果表明城市老年人更趋向于独立居住或入住养老机构,而农村老年人对社会养老服务的需求更取决于家庭成员的态度和支持程度.     

Assisted living and the aging trajectory

Assisted living (AL) is a caregiving option between independent living and nursing home placement. This study explores women residents' experience of AL in four Midwestern facilities, using interview and field research methods. We found that most residents wanted to stay in AL rather than move to a nursing home; they looked backward nostalgically toward home, and complied with staff rules and directives in order to remain in place. In contrast to nursing homes, AL allows residents to experience continuities with self and home: a private room, some of their own belongings, and access to relationships and activities associated with self and home. Given the expanded lifespan and growing popularity of AL, it is becoming a new stage in the trajectory of women's aging.     

生活满意度与养老院需求意愿的影响研究——江苏农村老年人的调查

在城镇化快速推进和家庭养老支持力弱化的背景下,农村老年人对养老院人住意愿也在发生变化。以人口老龄化严重、农村社会养老保险实现全覆盖的东部沿海经济发达省份江苏为例,运用Logistic旧归模型对农村老年人养老院的需求意愿进行实证分析。研究表明,农村老年人晚年生活满意度对养老院需求意愿存在负相关关系,即生活满意度低的老年人相比生活满意度高的老年人更倾向于选择入伟养老院。另外,农村老年人对养老院的需求意愿还受年龄、个人年收入、健康状况、存活儿子数和存活女儿数的影响。本研究的政策启示是,整合村组或社区中的多种力量,为农村老年人构建一个包含生活照料、精神慰藉等多方面的社会支持网络;科学预测农村人口老龄化水平和养老院的需求意愿,稳步推进农村地区养老机构事业发展;从农村地区实际出发,合理引导农村养老机构的资源配置和功能定位。     

Assisted Living and the Aging Trajectory

ABSTRACT

Assisted living (AL) is a caregiving option between independent living and nursing home placement. This study explores women residents' experience of AL in four Midwestern facilities, using interview and field research methods. We found that most residents wanted to stay in AL rather than move to a nursing home; they looked backward nostalgically toward home, and complied with staff rules and directives in order to remain in place. In contrast to nursing homes, AL allows residents to experience continuities with self and home: a private room, some of their own belongings, and access to relationships and activities associated with self and home. Given the expanded lifespan and growing popularity of AL, it is becoming a new stage in the trajectory of women's aging.     

机构养老服务效率研究--以厦门市为例

以厦门市为研究对象，在文献回顾的基础上，选取4个投入变量和3个产出变量对该市28家养老机构进行数据包络分析（ DEA），考察了机构养老服务的综合效率和规模效率情况，并运用Spearman等级相关分析和秩和检验，对养老服务效率与质量以及其他影响因素进行了筛查，通过拟合Tobit模型，发现养老机构的固定资产总值和是否隶属于医院等质量因素对机构养老服务效率产生负向影响。在此基础上，对我国的机构养老政策和发展方向提出意见和建议。     

At home with strangers: social exclusion and intimate labor in Anthony Chen’s Ilo Ilo (2013)

In Singapore, many middle-class families employ foreign domestic workers (FDWs) to take on care and domestic work. In this setup, female FDWs need to be “a part of the family” and “feel at home” to better perform and render intimate labor, but they are structurally displaced and prevented from being fully integrated in both their employer’s homes and in the host country. Ilo Ilo (2013), a debut film by a Singaporean director Anthony Chen, has poignantly portrayed this paradoxical relationship by showing a young boy’s growing affection to his Filipina maid, and how this brief yet enduring bond demonstrates migration’s effects on both the foreign helpers and the middle-class families employing them. This Singaporean family melodrama depicts the affective nature of migration by demonstrating how FDWs are positioned as an intimate yet excluded figure inside the employer’s homes. The contradiction between intimacy and social exclusion seen in the film also simultaneously describes and prescribes the FDW’s place in the host country. The film illustrates the paradox of intimacy and exclusion in the host–guest worker relationship of employers and their maids within the private domains of household and the public discourse on FDWs’ claims in Singapore.     

Relationship between Familiarity, Attitudes and Preferences: Assisted Living Facilities as Compared to Nursing Homes

In this paper, the authors aim to (a) explore attitudes toward and preferences for living in the newly emerging place type of assisted living facilities in comparison to nursing homes, and (b) assess the possible impact of familiarity on those attitudes and preferences. Ninety-eight respondents (with a mean age of 62) were surveyed. Respondents were found to be more favorable toward assisted living facilities than nursing homes. A three-factor model was proposed in which attitudes mediated between familiarity and preferences. Increased familiarity seemed to predict enhanced favorable attitudes in the case of assisted living facilities, as opposed to unfavorable attitudes in the case of nursing homes. However, positive attitudes seemed to predict preferences for living in either place type. Results are discussed with regards to the literature on the mere exposure effect and long-term care for older adults.     

Aging in America: Limits to life span and elderly care options

Expanding longevity among the elderly and fertility decline are contributing to an aging US population. The number of persons 65 years or older is projected to double from about 32 million in 1990 to 66 million by 2030; the elderly proportion is expected to increase from 13 to 22 percent over the same period. Chronic illness and functional disability afflicts a significant proportion of older persons. An estimated 80–85 percent of people over age 65 have at least one chronic illness, and nearly one-half of older people report that chronic illness limits their activity to some degree. Altogether, about one-third of the population over 65 may need some kind of medical or social assistance. This paper discusses the three primary modes of care available to older persons: (1) the informal network of the family, (2) the more formal arrangements of home and community care, and (3) the institutionalized care of nursing homes. Of particular policy interest are the questions: Who provides the care? What type of care is available? Who receives the care? How much does each type of care cost? and Who pays? The current patterns and costs especially of long-term care provide a framework for planning future options. A discussion of research and policy recommendations concludes the paper.     

城市老年人选择养老院养老的影响因素研究--基于扎根理论的分析

随着社会组织形态和家庭结构的改变，养老院养老模式成为解决现代社会养老问题的必然选择。在对烟台市的42名老人进行深度访谈的基础上，运用扎根理论的开放式登录、关联式登录和核心式登录的三级编码技术，构建城市老年人选择养老院养老的影响因素模型。研究结果表明，影响城市老年人选择养老院养老的因素主要包括老人、子女和养老院因素三个方面，并据此给出了提升城市老年人选择养老院养老的对策建议。     

Consumption-led mobilized urbanism: socio-spatial separation in the second-home city of Sanya

Abstract

Tourism and recreational second-home development has increased rapidly in peripheral and lower tier cities of China in recent years. While tourism-led real estate development has been widely accepted as an effective investment opportunity, it can increase urban segregation and stratification. This pattern is seen in the resort city of Sanya on Hainan Island, China. Sanya’s recreational second homes vary in form and can be categorized into (1) elite-vacation second homes (short stay, private homes), (2) lifestyle-migration second homes (short stay, commercial homes), and (3) retirement-migration second homes (longer term, seasonal homes). Unlike the segregated cities formed by displaced labor migrants in many of China’s cities, seasonal recreational migrants are both economically better-off and are emerging as a dominant political force. The segregated residential spaces created by Sanya’s second-home development landscape further limits interaction and social network building between indigenous local residents and part-time recreational migrants. The perceived home space and feelings of place attachment towards Sanya is under drastic change, with locals feeling increasingly displaced. The new mosaic of consumption-led amenity cities in developing economies is one where traditional models of migration-based segregation are reversed. Wealthier second-home migrants have the capacity for more political power than local residents, as well as relying more on non-localized social networks and multi-nodal home spaces. Consumption-led mobility is an important determinant in building explanations of socio-spatial segregation and stratification in global cities that are undergoing dramatic development change.     

Ranking Nursing Homes’ Performances Through a Latent Markov Model with Fixed and Random Effects

Social Indicators Research - In this paper, we aim at ranking a set of nursing homes based on their ability in maintaining their residents’ physical conditions as good as possible. In this...