scholarly journals Does Receiving Informal Care Lead to Better Health Outcomes? Evidence From China Longitudinal Healthy Longevity Survey

2021 ◽  
pp. 016402752110528
Author(s):  
Yixiao Wang ◽  
Wei Yang
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Informal Care ◽  
Fixed Effects ◽  
Population Aging ◽  
Functional Decline ◽  
Chinese Government ◽  
Fixed Effects Model ◽  
Term Care ◽  
Healthy Longevity

Population aging has become a global challenge. Drawing data from Chinese Longitudinal Healthy Longevity Survey 2008, 2011, and 2014, this study examines the effect of informal care receipt on functional limitations and depressive symptoms among older people in China using lagged fixed effects model. Our findings suggest that receiving informal care is significantly associated with a slower functional decline. We also find that this effect varies across different income groups. The protective effect of informal care is more pronounced among older people with higher income compared to those with lower income. We do not observe any significant associations between receiving informal care and depressive symptoms of older people. This study highlights a pressing need for the Chinese government to establish a comprehensive long-term care system.

scholarly journals Physical Health and Quality of Life among Older People in the Context of Chinese Culture

2021 ◽  
Vol 18 (13) ◽  
pp. 6798
Author(s):  
Lin Zhang ◽  
Xinjie Wei ◽  
Xueyao Ma ◽  
Zhihong Ren
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Physical Health ◽  
Chinese Culture ◽  
Population Aging ◽  
Negative Emotions ◽  
Chinese Government ◽  
Older Individuals ◽  
Healthy Longevity

Population aging has become a crucial problem in China. Recently, the Chinese government has adopted many strategies and policies to solve this problem and improve the quality of life of older individuals. The present study aimed to examine the effect of physical health on quality of life among older individuals in the context of Chinese culture and explore the potential mediating roles of positive cognition and negative emotions in the association between physical health and quality of life. Data were from the wave of 2017–2018 of the Chinese Longitudinal Healthy Longevity Survey. Data on physical health, quality of life, positive cognition, and negative emotions of 15,874 older people were included in the present study. Pathway analysis was conducted by using IBM SPSS AMOS 21.0, and double verified using PROCESS Macro for SPSS 3.5.3. Results showed that physical health was positively associated with quality of life among older individuals in the context of Chinese culture. The effect size was small to moderate. Positive cognition and negative emotions independently and serially mediated the linkage of physical health and quality of life. These findings provided empirical evidence for the activating event-belief-consequence theory of emotion and hierarchy of needs theory and indicated that Chinese older people focused more on physical health rather than mental health. Practitioners could teach older individuals strategies of emotion regulation and cognitive appraisal to improve the quality of life of older individuals.

scholarly journals Impact of Informal Care on Health Care Utilization Among Older People in China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 334-334
Author(s):  
Yixiao Wang
Keyword(s):  
Health Care ◽  
Older People ◽  
Informal Care ◽  
Outpatient Care ◽  
Inpatient Care ◽  
Health Care Expenditures ◽  
Chinese Government ◽  
Term Care ◽  
Variable Approach ◽  
The Impact

Abstract Population aging has become a challenge to long-term care and health care for the society. Using China as a case study, this paper assesses allocative efficiency of resources in informal care and health care, to explore the effectiveness of the policy, i.e., encouraging informal care as a more cost-effective way to reduce public health care spending. Drawing data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, this study examines the impact of informal care on utilization of health care as well as amount of health care expenditures among older people with functional limitations in China. Using random effects model with instrumental variable approach, our findings suggest that informal care significantly reduces the utilization of health care, primarily by reducing the utilization of outpatient care. However, informal care significantly increases the amount of inpatient care expenditures for inpatient care users. We do not observe significant association between informal care and amount of outpatient care expenditures for outpatient care users. This study highlights a pressing need for the Chinese government to support informal caregivers by taking economic values of informal caregiving into consideration, and to improve efficiency in inpatient care by a more integrated resource allocation mechanism

Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
André Hajek ◽  
Elżbieta Buczak-Stec ◽  
Hendrik van den Bussche ◽  
Marion Eisele ◽  
Anke Oey ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Assisted Living ◽  
Service Use ◽  
Oldest Old ◽  
Strong Association ◽  
Functional Decline ◽  
Term Care ◽  
Random Effects Models ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the <i>oldest old</i> longitudinally. <b><i>Methods:</i></b> Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. <b><i>Results:</i></b> Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. <b><i>Conclusion:</i></b> Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

scholarly journals The Impact of Environmental Pollution on the Health of Middle-Aged and Older Adults in China

2021 ◽  
Author(s):  
Hongli Fan ◽  
Yingcheng Wang ◽  
Ying Wang ◽  
Peter C Coyte
Keyword(s):  
Older Adults ◽  
Environmental Pollution ◽  
Fixed Effects ◽  
Elderly Women ◽  
Population Aging ◽  
Pollution Prevention ◽  
Fixed Effects Model ◽  
Middle Aged ◽  
The Government ◽  
The Impact

Abstract While several studies have demonstrated the negative impacts of environmental pollution on population health, in general, few studies have examined the potential differential effects on the health of middle-aged and older populations, i.e. 45 years and older. Given the twin concerns of environmental pollution and population aging in China, this article employed a fixed effects model to infer the impact of environmental pollution on public health with a particular focus on middle-aged and older adults. The analyses were based on data from the 2011–2018 waves of the CHARLS and pollutant data from prefecture-level cities. The results showed that environmental pollution significantly increased the risk of chronic diseases and negatively impacted the health of middle-aged and older adults. Environmental pollution had its greatest negative effect on the health of the elderly, women, urban residents and those with lower incomes than for their counterparts. We further found that the main channels of effect were through reduced physical exercise and an increase in depressive symptoms, and the pollution prevention actions alleviated the health deterioration of environmental pollution for the middle-aged and elderly. It is imperative for the government to urgently reinforce policy's enforcement to decrease air and water pollution, and enhance the ability to circumvent pollution for the lower socioeconomic groups.

scholarly journals Does long-term care coverage shape the impact of informal care-giving on quality of life? A difference-in-difference approach

2018 ◽  
Vol 40 (6) ◽  
pp. 1291-1308 ◽  
Author(s):  
Thijs van den Broek ◽  
Emily Grundy
Keyword(s):  
Quality Of Life ◽  
Informal Care ◽  
Fixed Effects ◽  
Long Term Care ◽  
Difference In Difference ◽  
Term Care ◽  
Care Giving ◽  
The Impact

AbstractThe impact that providing care to ageing parents has on adult children's lives may depend on the long-term care (LTC) context. A common approach to test this is to compare whether the impact of care-giving varies between countries with different LTC coverage. However, this approach leaves considerable room for omitted variable bias. We use individual fixed-effects analyses to reduce bias in the estimates of the effects of informal care-giving on quality of life, and combine this with a difference-in-difference approach to reduce bias in the estimated moderating impact of LTC coverage on these effects. We draw on longitudinal data for Sweden and Denmark from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected between 2004 and 2015. Both countries traditionally had generous LTC coverage, but cutbacks were implemented at the end of the 20th century in Sweden and more recently in Denmark. We use this country difference in the timing of the cutbacks to shed light on effects of LTC coverage on the impact care-giving has on quality of life. Our analyses show that care-giving was more detrimental for quality of life in Sweden than in Denmark, and this difference weakened significantly when LTC coverage was reduced in Denmark, but not in Sweden. This suggests that LTC coverage shapes the impact of care-giving on quality of life.

scholarly journals Future long-term care expenditure in Germany, Spain, Italy and the United Kingdom

2006 ◽  
Vol 26 (2) ◽  
pp. 285-302 ◽  
Author(s):  
ADELINA COMAS-HERRERA ◽  
RAPHAEL WITTENBERG ◽  
JOAN COSTA-FONT ◽  
CRISTIANO GORI ◽  
ALESSANDRA DI MAIO ◽  
...  
Keyword(s):  
United Kingdom ◽  
Older People ◽  
Informal Care ◽  
Long Term Care ◽  
Base Case ◽  
Term Care ◽  
Considerable Uncertainty ◽  
The United Kingdom ◽  
The Future

This paper reports findings from a European Commission funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom, and presents projections of future long-term care expenditure in the four countries under a number of assumptions about the future. Macro-simulation (or cell-based) models were used to make comparable projections based on a set of common assumptions. A central base-case served as a point of comparison by which to explore the sensitivity of the models to alternative scenarios for the key determinants. The sensitivity of the models to variant assumptions about the future numbers of older people, the prevalence of functional dependency and informal care, patterns of long-term provision, and macroeconomic conditions are examined. It was found that, under the base-case, the proportion of gross domestic product spent on long-term care is projected to more than double between 2000 and 2050 in each country. The projected future demand for long-term care services for older people is sensitive to assumptions about the future number of older people, the prevalence of dependency and the availability of informal care, and projected expenditure is sensitive to assumptions about rises in the real unit-costs of services and the structure of the models. It is important, for planning purposes, to recognise the considerable uncertainty about future levels of long-term care expenditure.

scholarly journals Are Confucius Institutes Building Blocks or Stumbling Blocks for Foreign Students in China: An Empirical Study of 190 Countries (1999–2015)

2020 ◽  
Vol 3 (2) ◽  
pp. 235-253
Author(s):  
Dongyang Chen ◽  
Wei Ha
Keyword(s):  
Foreign Students ◽  
Fixed Effects ◽  
Cultural Distance ◽  
Substitution Effect ◽  
Building Blocks ◽  
Chinese Government ◽  
Fixed Effects Model ◽  
Confucius Institutes ◽  
Source Countries ◽  
The Impact

Purpose: This study investigates the impact of Confucius Institutes on China’s international education initiatives. First, it examines whether the establishment of Confucius Institutes has a gravitational effect on the scale of foreign students coming to China. Second, it discerns whether there are any association between the establishment of Confucius Institutes and the attributes of foreign students based on the type of program they select. Third, it identifies whether there are any differences in the impact of Confucius Institutes based on constraints such as the number of foreign students, income levels, cultural distance, and geographical endowment. Design/Approach/Methods: Based on the trade gravity model and the push–pull theory, we estimated a two-way fixed-effects model using panel data of all source countries from 1999 to 2015. Findings: Results show that Confucius Institutes have helped China attract more foreign students on Chinese government scholarships, with each Institute increasing such enrolment by 1.3%. However, Confucius Institutes have resulted in a drop in the total number of foreign students studying in China, especially nondegree students. This substitution effect means that the Institutes actually help China improve the composition of its foreign students. Further heterogeneity analysis shows that the substitution effect is primarily driven by the main source countries. Accordingly, this study suggests that China should establish more Confucius Institutes in Africa and Eastern Europe to maximize the catalyzing effect of Confucius Institutes. Originality/Value: In contrast to previous studies on foreign scholarship in China, this study examines all 190 source countries from 1999 to 2015. This comprehensive study also explores the heterogeneous effects of foreign students on trade across economic, cultural, and geographical domains.

scholarly journals Informal and paid care for Brazilian older adults (National Health Survey, 2013)

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Maria Fernanda Lima-Costa ◽  
Sérgio Viana Peixoto ◽  
Deborah Carvalho Malta ◽  
Célia Landmann Szwarcwald ◽  
Juliana Vaz de Melo Mambrini
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
National Health ◽  
Health Survey ◽  
Population Aging ◽  
Functional Limitations ◽  
Sociodemographic Factors ◽  
National Health Survey ◽  
Community Dwelling ◽  
Term Care

ABSTRACT OBJECTIVE To describe the prevalence and sociodemographic factors associated with informal and paid care for Brazilian older adults with functional limitations. METHODS Of the 23,815 participants of the National Health Survey aged 60 or older, 5,978 reported needing help to perform activities of daily living and were included in this analysis. The dependent variable was the source of care, categorized as exclusively informal (unpaid), exclusively formal (paid), mixed or none. The socio-demographic variables were age (60-64, 65-74, ≥ 75 years old), gender and number of residents in the household (1, 2, ≥ 3). The multivariate analysis was based on binomial and multinomial logistic regressions. RESULTS Informal care predominated (81.8%), followed by paid (5.8%) or mixed (6.8%) and no care (5.7%). The receipt of care from any source increased gradually with the number of residents in a same household, regardless of age and gender (OR = 4.85 and 9.74 for 2 and ≥ 3, respectively). Age was positively associated with receiving any care while the male gender showed a negative association. The number of residents in the household showed the strongest association with informal care (OR = 10.94 for ≥ 3 residents), compared with paid (OR = 5.48) and mixed (OR = 4.16) care. CONCLUSIONS Informal care is the main source of help for community-dwelling older adults with functional limitations. In a context of rapid population aging and decline in family size, the results reinforce the need for policies to support long-term care for older Brazilians.

scholarly journals Mapping the Future of Family Care: Receipt of Informal Care by Older People with Disabilities in England to 2032

2012 ◽  
Vol 11 (4) ◽  
pp. 533-545 ◽  
Author(s):  
Linda Pickard ◽  
Raphael Wittenberg ◽  
Adelina Comas-Herrera ◽  
Derek King ◽  
Juliette Malley
Keyword(s):  
Older People ◽  
Informal Care ◽  
Family Care ◽  
People With Disabilities ◽  
Developed Countries ◽  
Policy Implications ◽  
Term Care ◽  
The Future ◽  
Future Supply ◽  
Care Systems

Many long-term care systems in economically developed countries are reliant on informal care. However, in the context of population ageing, there are concerns about the future supply of informal care. This article reports on projections of informal care receipt by older people with disabilities from spouses and (adult) children to 2032 in England. The projections show that the proportions of older people with disabilities who have a child will fall by 2032 and that the extent of informal care in future may be lower than previously estimated. The policy implications, in the context of the Dilnot Commission's report, are explored.

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