The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce br...The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce briefly the long-term care insurance system in German, Japan and America for our learning. Therefore, China＇s long-term care insurance system could not totally indiscriminately imitate the mandatory long-term care insurance system in German and Japan, it also could not copy the business model of nursing insurance system in America. The conclusion is that long-term care insurance system in China should use the experience of developed countries based on the basic national conditions, doing some relative works, such as establishing policies and regulations, strengthening personnel training, and improving the market specification.展开更多
With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and t...With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.展开更多
The aging population of Shanghai is China one of the most serious city, is also one of the cities of the aging problem is prominent. As a result, the city＇s endowment pressure also with aging and aging aggravate grad...The aging population of Shanghai is China one of the most serious city, is also one of the cities of the aging problem is prominent. As a result, the city＇s endowment pressure also with aging and aging aggravate gradually increased, especially the old man nursing problems become the main problem in society. Study abroad to establish a long term care insurance comprehensive factors, considering the feasibility of the long-term care insurance in Shanghai, alleviate the pressure of the pension, the construction of a harmonious society.展开更多
Worldwide,welfare is trending from a welfare state model to social participation to ensure the sustainability of health care systems.Japan,where the aging rate will reach 40%by 2060,reformed public Long-Term Care Insu...Worldwide,welfare is trending from a welfare state model to social participation to ensure the sustainability of health care systems.Japan,where the aging rate will reach 40%by 2060,reformed public Long-Term Care Insurance(LTCI)on a large scale in 2015 and started the Comprehensive Service project(CS project),which emphasizes the prevention of long-term care through social participation in the community.Through this project,communities work to develop prevention efforts revolving around the community salon/caféand mutual support,including all daily tasks that previously were the purview of family members.Each municipality has an obligation to promote a CS project through new community development initiatives among community members.The purpose of this study is to investigate the CS projects performed by rural municipalities and to explore the important factors for their success.The authors used a case study methodology and constant comprehensive methodology for analyzing interview data to pull out the elements of successful initiatives.The study shows that the following factors influence success:recognition of demographic risk,recognition of the ineffectiveness of LTCI services,developing a passionate philosophy and strategy as a municipality,developing community members’initiative,and having many assets and full participation in the community.These factors imply that community development is a critical part of any successful CS project.展开更多
It is a long-term strategic task for China to cope with the aging population and declining birthrate. Therefore, our country has begun to gradually establish our long-term care security system, and the pricing problem...It is a long-term strategic task for China to cope with the aging population and declining birthrate. Therefore, our country has begun to gradually establish our long-term care security system, and the pricing problem of long-term care insurance has gradually attracted the attention of academic circles. The pricing model and nursing demand of long-term care insurance have been repeatedly discussed and studied, and many useful conclusions have been formed. However, in terms of rates, the rates of both commercial long-term care insurance and policy products are on the high side. At present, the price of commercial long-term care insurance is high. Although the price of policy-oriented products is low, the level of protection is also low, which cannot provide sufficient protection. This study explores the introduction of capping line into long-term care insurance to reduce the rate level of long-term care insurance. Using the existing state transition matrix, through empirical research, the pricing of long-term care insurance with capping line is made in order to provide suggestions for the development of long-term care insurance.展开更多
Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independentl...Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.展开更多
The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. Howe...The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. However, the prevalence of current pension model has a pension without medical care, health care and pension separate and other issues, so the development of ＂medical support combined with pension＂ long-term care insurance system is imperative. Based on the study to explore parts of the country which operate basic pension model of＂medical pension combination＂, we analyze the necessity and feasibility of the implementation of Shanghai ＂medical support combined with pension ＂ long-term care insurance system, by summing up experiences and lessons, put forward some of the recommendations for the development in Shanghai ＂medical support combined with pension＂ type of long-term care system.展开更多
Shanghai went into the ranks of the aging society in 1979, as the first area which entered into the aging society in China. Along with the arrival of the ageing, the nursing problems of the old man and disabled elderl...Shanghai went into the ranks of the aging society in 1979, as the first area which entered into the aging society in China. Along with the arrival of the ageing, the nursing problems of the old man and disabled elderly become the important factors which affect social development. The establishment of the legal system, System integration to realize resource optimal allocation, Division of multilevel optimization services provide new pattern can make it happen.展开更多
With the gradual development of society, scientific and technological progress, aging gradually aggravated, has become a hot topic of society. People to old age, self-care ability than in the past, not only suffer fro...With the gradual development of society, scientific and technological progress, aging gradually aggravated, has become a hot topic of society. People to old age, self-care ability than in the past, not only suffer from disease, life has become difficult, coupled with the large number of empty nest family, the cost of care is also very high, whether it is to receive home care or professional institutions of care have great difficulties. Therefore, the community should be a large number of people with long-term care needs of the appropriate economic compensation, in this context, long-term care insurance is born. As a leading city in Shandong Province, Qingdao has introduced long-term care insurance and achieved good results. This paper analyzes the practical problems faced by Qingdao, that is, the development background of Qingdao long-term nursing insurance model, obtains the deficiency of Qingdao long-term nursing insurance, and then puts forward the corresponding countermeasures, and then ponders how to choose the long-term nursing insurance model of our country＇s future development.展开更多
Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Inform...Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Information on NSCLC patients diagnosed in 2008 was derived from the Beijing Cancer Registry.The medical records of 1,134 cases were sampled and re-surveyed to obtain information on potential risk factors.Poorly-insured status was defined as Uninsured and New Rural Cooperative Medical Insurance Scheme(NRCMS),while well-insured included Urban Employees Basic Medical Insurance(UEBMI) and Free Medical Care(FMC).To estimate survival outcomes, individuals were followed-up until December 31, 2018. Cancer-specific survival probabilities at 5 and 10 years after diagnosis were estimated using the Kaplan-Meier method. Log-rank test was used to compare long-term survival with different characteristics. Multivariable Cox proportional hazard regression model was used to examine the relative effect of insurance status on cancer-specific mortality.Results: Well-insured NSCLC patients have longer cancer-specific survival than poorly-insured individuals[hazard ratio(HR)=0.81;95% confidence interval(95% CI): 0.67-0.97), even after adjusting for age, gender, cancer stage, smoking status, family history and residential area. Older age and rural residence were associated with a higher risk of cancer-specific mortality(HR=1.03;95% CI: 1.02-1.03 and HR=1.25;95% CI: 1.07-1.46,respectively). Smoking individuals had a 41% higher long-term cancer-specific mortality risk than non-smoking ones(HR=1.41;95% CI: 1.20-1.66).Conclusions: NSCLC patients with good insurance status had better survival rates than those with poor insurance. An association was significant even after 10 years. Large population-based studies are needed to validate that high reimbursement insurance status can lead to the improvement of long-term cancer prognosis in China.展开更多
Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hos...Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.展开更多
This review addresses the critical intersection between acute poisoning and the associated psychological trauma,highlighting the need to bridge the gap between emergency care and long-term mental health rehabilitation...This review addresses the critical intersection between acute poisoning and the associated psychological trauma,highlighting the need to bridge the gap between emergency care and long-term mental health rehabilitation.The global incidence of acute poisoning varies,showing different demographic patterns in psychological trauma post-poisoning,with suicide attempts accounting for approximately 76%of cases in some cohorts.Additionally,an estimated 385 million unintentional pesticide poisonings occur annually worldwide.A comprehensive understanding of the biological and neurobiological mechanisms involved—along with accurate diagnostic strategies and treatment methods—is essential.Multidisciplinary and integrated care approaches associated with a reduction in allcause mortality(odds ratio:0.52)and significant symptom burden relief,along with technological and therapeutic innovations,are essential for improving patient outcomes.Finally,this review outlines policy and research recommendations to enhance integrated care systems for the better management of acute poisoning and its associated psychological trauma.展开更多
Objectives:With the rapid aging of populations worldwide,the long-term care(LTC)industry has become a critical arena for both social welfare and entrepreneurial development,particularly among women who play a leading ...Objectives:With the rapid aging of populations worldwide,the long-term care(LTC)industry has become a critical arena for both social welfare and entrepreneurial development,particularly among women who play a leading role in caregiving enterprises.However,female LTC entrepreneurs often face emotional strain and limited social resources that affect their professional well-being.This study investigates the effects of psychological resilience and social capital on the well-being of female entrepreneurs in the long-term care(LTC)industry and examines the mediating role of entrepreneurial competence.Methods:A mixed-methods design was employed.Quantitative data were collected from 73 female LTC entrepreneurs in Taiwan through structured questionnaires,and correlation,regression,and mediation analyses were conducted.Complementary qualitative interviews with eight entrepreneurs provided deeper insights into how resilience and social resources are mobilized in entrepreneurial practice.Results:Psychological resilience and social capital were positively associated with well-being(β=0.41,p<0.001;β=0.36,p=0.002),jointly explaining 47%of its variance.Entrepreneurial competence partially mediated the resilience–well-being relationship(indirect effect=0.18,95%CI[0.07,0.32]).These effects were statistically and practically meaningful.Conclusion:Psychological resilience and social capital jointly enhance the well-being of female LTC entrepreneurs,with entrepreneurial competence serving as a partial mediator.The results suggest that fostering both inner strength and social connectedness can promote sustainable well-being and professional growth in the long-term care sector.展开更多
1990s, Germany is facing a serious problem of population aging, in 1995, of the population over the age of 60 in Germany, the proportion of the total population is as high as 21%, the proportion is expected to rise to...1990s, Germany is facing a serious problem of population aging, in 1995, of the population over the age of 60 in Germany, the proportion of the total population is as high as 21%, the proportion is expected to rise to 36% in 2030. The growing demand for long-term care services by the rapid aging of population is the basic background of the introduction of the long-term care insurance system in Germany.展开更多
Population aging has become a global social problem, the problem in our country has become the core of the aging problem. With the gradual aging of the elderly, loss of energy, loss of energy has become the norm for t...Population aging has become a global social problem, the problem in our country has become the core of the aging problem. With the gradual aging of the elderly, loss of energy, loss of energy has become the norm for the elderly or sick elderly. According to the Ministry of Civil Affairs statistics, as of the end of 2014, the number of disabled elderly in China reached 35 million, about 90% of the disabled elderly need professional care services and professional treatment to ease the pain. In order to deal with the social problems brought about by the aging of the population, in July 1, 2012, Qingdao City, the first in the country to establish a long-term health care insurance system, has taken a key step to crack the problem of aging. In this paper, the situation of Qingdao long term care insurance system as the research object, taking Qingdao city as study sites, according to statistical data analysis of the implementation effect of long-term local health care policy, and through questionnaires and interviews in the form of local residents to participate in the investigation of awareness, and perception. At the same time, the results of the survey on long-term health care insurance system in Qingdao, the operation effect of the overall analysis.展开更多
In twenty-first Century. the speed of population aging in China was accelerated, the growth of the disabled populationaccelerated and the demand for the existing long-term care service was challenging. It is imminent ...In twenty-first Century. the speed of population aging in China was accelerated, the growth of the disabled populationaccelerated and the demand for the existing long-term care service was challenging. It is imminent to establish a system that can meet the long-term care needs of the disabled population, As a pilot city of long-term care insurance. Shanghai has a Fund for the long-term care insurance system. To compare and analyze the related elements of raising, service content and payment, combined with the experience ol long-term nursing insurance in foreign countries, and considering its application in community pension, it has certain reference significance for the design of long-term nursing insurance system in China.展开更多
With the accelerating process of population aging in our country, the physical function of the elderly will decline, the possibility of suffering from acute and chronic diseases will increase, and the occurrence of di...With the accelerating process of population aging in our country, the physical function of the elderly will decline, the possibility of suffering from acute and chronic diseases will increase, and the occurrence of disability will become more common and normal. The potential demand for elderly care is rapidly increasing. With the growth, the care of the disabled elderly has become increasingly acute. At the same time, due to the intensification of family miniaturization and population migration, the traditional family-based long-term care has been difficult to sustain. How to incorporate long-term care into our social security system as soon as possible has become the focus of the whole society. The thesis through the combination of public policy simulation methods and the research data, the long-term care insurance system implemented at the beginning of 2018 in Shanghai is a policy blueprint. It uses statistical software SPSS, MATLAB, etc. to achieve data collation, analysis and prediction, and at the same time integrates the pilot of the long-term care insurance system. The implementation of policies in cities such as Qingdao and Nantong has been simulated. Finally, on the basis of simulation results, suggestions have been made for the future development of China＇s long-term care insurance system.展开更多
Objectives:This study aimed to explore the dignity and related factors among older adults in long-term care facilities.Methods:Cross-sectional data were obtained from a sample of 253 Chinese older adults dwelling in l...Objectives:This study aimed to explore the dignity and related factors among older adults in long-term care facilities.Methods:Cross-sectional data were obtained from a sample of 253 Chinese older adults dwelling in long-term care facilities.Dignity among older adults was measured using the Dignity Scale,and its potential correlates were explored using multiple linear regressions.Results:Results showed that the total score of the Dignity Scale is 151.95±11.75.From high to low,the different factors of dignity among older adults in long-term care facilities were as follows:caring factors(4.83±0.33),social factors(4.73±0.41),psychological factors(4.66±0.71),value factors(4.56±0.53),autonomous factors(4.50±0.57),and physical factors(4.38±0.55).A higher score of the Dignity Scale was associated with higher economic status,fewer chronic diseases,less medication,better daily living ability and long-time lived in cities.Conclusion:Older adults with low economic status,more chronic diseases,and poor daily living ability,taking more medications,or the previous residence in rural areas seem to be most at low-level dignity in long-term care facilities and thus require more attention than their peers.展开更多
Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic ...Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.展开更多
文摘The objective is to explore the foundation of the elderly long-term care insurance system in China, which is to face the problem resulted from aging of the population. Adopting the contrastive analysis to introduce briefly the long-term care insurance system in German, Japan and America for our learning. Therefore, China＇s long-term care insurance system could not totally indiscriminately imitate the mandatory long-term care insurance system in German and Japan, it also could not copy the business model of nursing insurance system in America. The conclusion is that long-term care insurance system in China should use the experience of developed countries based on the basic national conditions, doing some relative works, such as establishing policies and regulations, strengthening personnel training, and improving the market specification.
文摘With the aging of the country’s population structure,the problem of social pensions is becoming more and more serious.As for the issue of social pension,the elderly with Alzheimer’s disease are a special group,and the issue of care services for these elderly has attracted widespread attention from society.However,judging from the current level of social security provided to the elderly with dementia in the country,there is a serious imbalance between supply and demand.Therefore,this problem needs to be solved urgently and is of great significance for further improving the country’s social pension security system.Routine care is limited to hospitals and mainly focuses on the patient’s condition.Patients fail to receive comprehensive care services and the effect is not ideal.Therefore,in order to improve patients’cognitive function and quality of life,and learn from international experience,a“community-institution-home”three-dimensional linkage care model based on long-term care insurance can be established.The application of this model can effectively solve and further improve the country’s elderly care and social security system.
文摘The aging population of Shanghai is China one of the most serious city, is also one of the cities of the aging problem is prominent. As a result, the city＇s endowment pressure also with aging and aging aggravate gradually increased, especially the old man nursing problems become the main problem in society. Study abroad to establish a long term care insurance comprehensive factors, considering the feasibility of the long-term care insurance in Shanghai, alleviate the pressure of the pension, the construction of a harmonious society.
基金supported by JSPS(Japan Society for the Promotion of Science)KAKENHI(17K04251)of Grant-in-Aid for Scientific Research(C)and a Tokyo Kasei University Research Project Grant.
文摘Worldwide,welfare is trending from a welfare state model to social participation to ensure the sustainability of health care systems.Japan,where the aging rate will reach 40%by 2060,reformed public Long-Term Care Insurance(LTCI)on a large scale in 2015 and started the Comprehensive Service project(CS project),which emphasizes the prevention of long-term care through social participation in the community.Through this project,communities work to develop prevention efforts revolving around the community salon/caféand mutual support,including all daily tasks that previously were the purview of family members.Each municipality has an obligation to promote a CS project through new community development initiatives among community members.The purpose of this study is to investigate the CS projects performed by rural municipalities and to explore the important factors for their success.The authors used a case study methodology and constant comprehensive methodology for analyzing interview data to pull out the elements of successful initiatives.The study shows that the following factors influence success:recognition of demographic risk,recognition of the ineffectiveness of LTCI services,developing a passionate philosophy and strategy as a municipality,developing community members’initiative,and having many assets and full participation in the community.These factors imply that community development is a critical part of any successful CS project.
文摘It is a long-term strategic task for China to cope with the aging population and declining birthrate. Therefore, our country has begun to gradually establish our long-term care security system, and the pricing problem of long-term care insurance has gradually attracted the attention of academic circles. The pricing model and nursing demand of long-term care insurance have been repeatedly discussed and studied, and many useful conclusions have been formed. However, in terms of rates, the rates of both commercial long-term care insurance and policy products are on the high side. At present, the price of commercial long-term care insurance is high. Although the price of policy-oriented products is low, the level of protection is also low, which cannot provide sufficient protection. This study explores the introduction of capping line into long-term care insurance to reduce the rate level of long-term care insurance. Using the existing state transition matrix, through empirical research, the pricing of long-term care insurance with capping line is made in order to provide suggestions for the development of long-term care insurance.
文摘Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.
文摘The aging development in Shanghai shows speed, high degree of aging, the number of elderly people living alone increased and other trends, the contradiction between degree of aging and care become more prominent. However, the prevalence of current pension model has a pension without medical care, health care and pension separate and other issues, so the development of ＂medical support combined with pension＂ long-term care insurance system is imperative. Based on the study to explore parts of the country which operate basic pension model of＂medical pension combination＂, we analyze the necessity and feasibility of the implementation of Shanghai ＂medical support combined with pension ＂ long-term care insurance system, by summing up experiences and lessons, put forward some of the recommendations for the development in Shanghai ＂medical support combined with pension＂ type of long-term care system.
文摘Shanghai went into the ranks of the aging society in 1979, as the first area which entered into the aging society in China. Along with the arrival of the ageing, the nursing problems of the old man and disabled elderly become the important factors which affect social development. The establishment of the legal system, System integration to realize resource optimal allocation, Division of multilevel optimization services provide new pattern can make it happen.
文摘With the gradual development of society, scientific and technological progress, aging gradually aggravated, has become a hot topic of society. People to old age, self-care ability than in the past, not only suffer from disease, life has become difficult, coupled with the large number of empty nest family, the cost of care is also very high, whether it is to receive home care or professional institutions of care have great difficulties. Therefore, the community should be a large number of people with long-term care needs of the appropriate economic compensation, in this context, long-term care insurance is born. As a leading city in Shandong Province, Qingdao has introduced long-term care insurance and achieved good results. This paper analyzes the practical problems faced by Qingdao, that is, the development background of Qingdao long-term nursing insurance model, obtains the deficiency of Qingdao long-term nursing insurance, and then puts forward the corresponding countermeasures, and then ponders how to choose the long-term nursing insurance model of our country＇s future development.
基金supported by grants from the National Natural Science Foundation of China (No.81600070)Science Foundation of Peking University Cancer Hospital (No.2020-10)。
文摘Objective: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer(NSCLC) in Beijing, China, using a population-based cancer registry data.Methods: Information on NSCLC patients diagnosed in 2008 was derived from the Beijing Cancer Registry.The medical records of 1,134 cases were sampled and re-surveyed to obtain information on potential risk factors.Poorly-insured status was defined as Uninsured and New Rural Cooperative Medical Insurance Scheme(NRCMS),while well-insured included Urban Employees Basic Medical Insurance(UEBMI) and Free Medical Care(FMC).To estimate survival outcomes, individuals were followed-up until December 31, 2018. Cancer-specific survival probabilities at 5 and 10 years after diagnosis were estimated using the Kaplan-Meier method. Log-rank test was used to compare long-term survival with different characteristics. Multivariable Cox proportional hazard regression model was used to examine the relative effect of insurance status on cancer-specific mortality.Results: Well-insured NSCLC patients have longer cancer-specific survival than poorly-insured individuals[hazard ratio(HR)=0.81;95% confidence interval(95% CI): 0.67-0.97), even after adjusting for age, gender, cancer stage, smoking status, family history and residential area. Older age and rural residence were associated with a higher risk of cancer-specific mortality(HR=1.03;95% CI: 1.02-1.03 and HR=1.25;95% CI: 1.07-1.46,respectively). Smoking individuals had a 41% higher long-term cancer-specific mortality risk than non-smoking ones(HR=1.41;95% CI: 1.20-1.66).Conclusions: NSCLC patients with good insurance status had better survival rates than those with poor insurance. An association was significant even after 10 years. Large population-based studies are needed to validate that high reimbursement insurance status can lead to the improvement of long-term cancer prognosis in China.
文摘Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.
文摘This review addresses the critical intersection between acute poisoning and the associated psychological trauma,highlighting the need to bridge the gap between emergency care and long-term mental health rehabilitation.The global incidence of acute poisoning varies,showing different demographic patterns in psychological trauma post-poisoning,with suicide attempts accounting for approximately 76%of cases in some cohorts.Additionally,an estimated 385 million unintentional pesticide poisonings occur annually worldwide.A comprehensive understanding of the biological and neurobiological mechanisms involved—along with accurate diagnostic strategies and treatment methods—is essential.Multidisciplinary and integrated care approaches associated with a reduction in allcause mortality(odds ratio:0.52)and significant symptom burden relief,along with technological and therapeutic innovations,are essential for improving patient outcomes.Finally,this review outlines policy and research recommendations to enhance integrated care systems for the better management of acute poisoning and its associated psychological trauma.
文摘Objectives:With the rapid aging of populations worldwide,the long-term care(LTC)industry has become a critical arena for both social welfare and entrepreneurial development,particularly among women who play a leading role in caregiving enterprises.However,female LTC entrepreneurs often face emotional strain and limited social resources that affect their professional well-being.This study investigates the effects of psychological resilience and social capital on the well-being of female entrepreneurs in the long-term care(LTC)industry and examines the mediating role of entrepreneurial competence.Methods:A mixed-methods design was employed.Quantitative data were collected from 73 female LTC entrepreneurs in Taiwan through structured questionnaires,and correlation,regression,and mediation analyses were conducted.Complementary qualitative interviews with eight entrepreneurs provided deeper insights into how resilience and social resources are mobilized in entrepreneurial practice.Results:Psychological resilience and social capital were positively associated with well-being(β=0.41,p<0.001;β=0.36,p=0.002),jointly explaining 47%of its variance.Entrepreneurial competence partially mediated the resilience–well-being relationship(indirect effect=0.18,95%CI[0.07,0.32]).These effects were statistically and practically meaningful.Conclusion:Psychological resilience and social capital jointly enhance the well-being of female LTC entrepreneurs,with entrepreneurial competence serving as a partial mediator.The results suggest that fostering both inner strength and social connectedness can promote sustainable well-being and professional growth in the long-term care sector.
文摘1990s, Germany is facing a serious problem of population aging, in 1995, of the population over the age of 60 in Germany, the proportion of the total population is as high as 21%, the proportion is expected to rise to 36% in 2030. The growing demand for long-term care services by the rapid aging of population is the basic background of the introduction of the long-term care insurance system in Germany.
文摘Population aging has become a global social problem, the problem in our country has become the core of the aging problem. With the gradual aging of the elderly, loss of energy, loss of energy has become the norm for the elderly or sick elderly. According to the Ministry of Civil Affairs statistics, as of the end of 2014, the number of disabled elderly in China reached 35 million, about 90% of the disabled elderly need professional care services and professional treatment to ease the pain. In order to deal with the social problems brought about by the aging of the population, in July 1, 2012, Qingdao City, the first in the country to establish a long-term health care insurance system, has taken a key step to crack the problem of aging. In this paper, the situation of Qingdao long term care insurance system as the research object, taking Qingdao city as study sites, according to statistical data analysis of the implementation effect of long-term local health care policy, and through questionnaires and interviews in the form of local residents to participate in the investigation of awareness, and perception. At the same time, the results of the survey on long-term health care insurance system in Qingdao, the operation effect of the overall analysis.
文摘In twenty-first Century. the speed of population aging in China was accelerated, the growth of the disabled populationaccelerated and the demand for the existing long-term care service was challenging. It is imminent to establish a system that can meet the long-term care needs of the disabled population, As a pilot city of long-term care insurance. Shanghai has a Fund for the long-term care insurance system. To compare and analyze the related elements of raising, service content and payment, combined with the experience ol long-term nursing insurance in foreign countries, and considering its application in community pension, it has certain reference significance for the design of long-term nursing insurance system in China.
文摘With the accelerating process of population aging in our country, the physical function of the elderly will decline, the possibility of suffering from acute and chronic diseases will increase, and the occurrence of disability will become more common and normal. The potential demand for elderly care is rapidly increasing. With the growth, the care of the disabled elderly has become increasingly acute. At the same time, due to the intensification of family miniaturization and population migration, the traditional family-based long-term care has been difficult to sustain. How to incorporate long-term care into our social security system as soon as possible has become the focus of the whole society. The thesis through the combination of public policy simulation methods and the research data, the long-term care insurance system implemented at the beginning of 2018 in Shanghai is a policy blueprint. It uses statistical software SPSS, MATLAB, etc. to achieve data collation, analysis and prediction, and at the same time integrates the pilot of the long-term care insurance system. The implementation of policies in cities such as Qingdao and Nantong has been simulated. Finally, on the basis of simulation results, suggestions have been made for the future development of China＇s long-term care insurance system.
基金This work was supported by the Health Commission of Zhejiang Province(Grant number 2018KY544,2018).
文摘Objectives:This study aimed to explore the dignity and related factors among older adults in long-term care facilities.Methods:Cross-sectional data were obtained from a sample of 253 Chinese older adults dwelling in long-term care facilities.Dignity among older adults was measured using the Dignity Scale,and its potential correlates were explored using multiple linear regressions.Results:Results showed that the total score of the Dignity Scale is 151.95±11.75.From high to low,the different factors of dignity among older adults in long-term care facilities were as follows:caring factors(4.83±0.33),social factors(4.73±0.41),psychological factors(4.66±0.71),value factors(4.56±0.53),autonomous factors(4.50±0.57),and physical factors(4.38±0.55).A higher score of the Dignity Scale was associated with higher economic status,fewer chronic diseases,less medication,better daily living ability and long-time lived in cities.Conclusion:Older adults with low economic status,more chronic diseases,and poor daily living ability,taking more medications,or the previous residence in rural areas seem to be most at low-level dignity in long-term care facilities and thus require more attention than their peers.
文摘Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.
