Cross-national policy learning in health system reform: The case of Diagnosis Related Groups

Observations of policy convergence and the cross-national diffusion of ideas, knowledge and policies have raised the question about the ways countries might learn from their peers. This article examines the role of cross-national learning with regard to Diagnosis Related Groups (DRGs). We review the spread of this policy instrument and analyse the implementation of DRGs in three late-adopting countries: Germany, Switzerland and the Netherlands. The three cases show that the implementation of this policy instrument required intense studies, cooperation with stakeholders and adjustment to country-specific needs. The countries learned from foreign experience, but it was only with the introduction of a regulatory framework for competition between sickness funds that DRGs came fully onto the political agenda. While Germany and Switzerland drew upon foreign DRG models, the Netherlands developed an alternative system to classify patients according to case-mix.     

Numbers of children looked after in England: a historical analysis

This paper is an analysis of the relationship between policy, practice and the rates of children looked after by local authorities in England. It examines the trends in the numbers of children looked after by local authorities in England over a period of approximately 40 years. The increase in children looked after in the decade after 1994 is shown to be the result of fewer children entering care, but those that do tend to stay longer. This two-part dynamic appears to have been the underlying determinant of the care population over a long period of time. The fact that time spent in care is such a key factor suggests that planning for children who are already looked after is a crucial determinant of the numbers in care. However, it is argued that poorly developed family support services limit current options for reducing the size of the care population. A range of effective family support services could potentially have an impact on the number of children in care in three ways: by helping to maintain more children within their families; by identifying those children who need care earlier; and by improving the chances of some children being successfully returned home.     

“Fear Runs Deep:” The Anticipated Needs of LGBT Older Adults in Long-Term Care

Objectives: Older lesbian, gay, bisexual, and transgender (LGBT) adults are a vulnerable yet resilient population who face unique stressors as they foresee health decline. This paper presents the results of a study about community-dwelling LGBT older adults’ anticipated needs and fears related to nursing homes and assisted living. Methods: This qualitative study collected data through seven focus groups. The sample (N = 50) consisted of LGBT-identified adults age 55 and over. We used an inductive, thematic analysis approach to data analysis. Results: Participants seek an inclusive environment where they will be safe and feel connected to a community. They fear dependence on healthcare providers, dementia, mistreatment, and isolation. Importantly, these fears can lead to identity concealment and psychological distress, including suicide ideation. Discussion: This study adds to the existing literature about the worries of older LGBT adults as they anticipate long-term care. The results suggest that older LGBT adults seek LGBT-inclusive residential care settings that encompass two distinct yet related aspects of LGBT-affirmative care: the procedural (e.g. culturally competent skills and knowledge of practitioners) and the implicit (e.g. the values and mission of the organization). This paper identifies implications for practice, policy, and training.     

农村高龄老人的照料需求与照料供给分析

本文利用2005年"中国高龄老人健康长寿调查"跟踪调查的数据,通过对照料需求和照料供给的分析,揭示出农村高龄老人的照料现状并提出解决供需矛盾的对策。研究结果表明,我国农村地区有1/3的高龄老人需要他人提供某种日常生活方面的帮助,女性的照料需求高于男性。大多数农村高龄老人能够获得较为满意的家庭照料,但是社区照料基本处于空白,同时机构照料也处于发展的低级阶段。鉴于农村特殊的经济社会环境,应继续鼓励和支持家庭照料,大力发展机构照料,而探索适合农村地区的社区照料服务也刻不容缓。     

High‐frequency family contact: a road to nowhere for infants

Understanding the practices which support the best interests of infants when placed in out‐of‐home care in the first year of life is a significant challenge. A study based in Victoria, Australia, explored the practice by the Children's Court of ordering high‐frequency contact (4–7 days a week) with the infant's mother and father when they are placed in care in the first year of life. A literature review revealed little attention to the issue of frequency of family contact for infants. An audit of case files of all infants in care in mid‐2007 showed that at 1 year follow‐up, there was no difference in the reunification rate for children with a period of high‐frequency contact and those with less contact with their mothers and fathers. Focus groups revealed deep divisions of opinion about high‐frequency family contact which are played out in the adversarial Children's Court system in Victoria. The study highlights the complexity of understanding and supporting the attachment relationships at this critical period in the infant's life.     

A comparison of social work education across South Africa and Japan in relation to the Global Standards for Social Work Education and Training

Sakaguchi H, Sewpaul V. A comparison of social work education across South Africa and Japan in relation to the Global Standards for Social Work Education and Training Int J Soc Welfare 2011: 20: 192–202 © 2009 The Author(s), International Journal of Social Welfare © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article draws on a one‐year study visit to the University of KwaZulu‐Natal, South Africa, interviews with field supervisors and students in Japan and reviews of the national frameworks of education in Japan and in South Africa. In doing so, the authors identify the similarities and differences in social work education across the two countries and they explore some of the historical and socio‐cultural factors that might account for the differences. There are some identifiable peculiarities in social work education in Japan, especially with the coalescing of care work and social work education. The lack of differentiation between care work and social work makes it difficult to narrow the scope of social work education and practice. National social work standards have been approved in South Africa and regulatory frameworks for social work education and practice have been long accepted, thus rendering ‘social work’ a protected title and a profession that is more entrenched compared with social work in Japan. The codes of ethics in Japan and South Africa are discussed with specific reference to their control functions in South Africa. The article concludes by discussing these comparisons in relation to the Global Standards for Social Work Education.     

居家式社区养老服务模式研究——以莫慧市为例

本文对家庭、社区和政府在老人照顾方面的角色和功能进行理论分析,结合笔者生活的城市社区养老服务的现状,提出社区养老服务的对策建议。     

民族自治地方农村养老问题与对策初探——以黔东南州锦屏县为例

民族自治地方农村养老工作与构建社会主义和谐社会、社会主义新农村建设、“三农”问题等紧密相关,养老工作能否解决好直接影响到农村的社会稳定、社会的和谐发展和“三农”问题的解决。民族自治地方农村经济相对落后、经济发展不平衡、人口分布不均衡、农村老年人口日益增多、农民工大量外出等现实,给传统养老方式带来了历史性的冲击。这要求建立具有时代特色和地方特色的养老方式。本文在进行充分的实地调查、分析黔东南苗族侗族自治州锦屏县农村现行的养老方式现状、养老方式存在问题的基础上,结合当地实际情况和借鉴其他地方的成功养老方式,提出具体可行的对策。     

和谐心灵：构建高校和谐德育的逻辑起点

党的十七大报告提出加强和改进思想政治工作要注重人文关怀和心理疏导,为高校思想政治工作的特殊形式——德育教育指明了方向。高校教育应以和谐德育为先,构建和谐心灵。其基本途径,一是加强人文关怀、塑造健康人格,二是加强心理疏导,推进心理健康教育。     

试析城市电力设施的布局规划思路及方法——以绍兴市市区电力设施的布局规划为例

电力设施是城市电力系统的重要组成部分,针对电力设施的布局规划,采用国内领先的规划策略和优化模型,在科学合理的负荷分布预测基础上,对城市变电站站址及廊道的结构进行全面优化,并提前将电网规划结果纳入城市规划中.