scholarly journals Urban–Rural Differences in Long-Term Care Service Status and Needs Among Home-Based Elderly People in China

2020 ◽  
Vol 17 (5) ◽  
pp. 1701
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

scholarly journals Urban-rural differences in long-term care service status and needs among home-based elderly people in China

2019 ◽  
Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Ying Han ◽  
Lixia Wang ◽  
Ya Fang
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Long Term Care ◽  
The Elderly ◽  
Influential Factors ◽  
Term Care ◽  
Home Based ◽  
Urban Rural ◽  
Young Old

Abstract Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban-rural differences. This study aims to evaluate the differences of LTC current status and needs between urban-rural areas and to identify influencing factors causing the different LTC needs. Methods: The data comes from the Chinese Longitudinal Health Longevity Survey in 2014. 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (P＜0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health, and less autonomy had higher anticipated needs for LTC services (ORs>1, P＜0.01). Compared with the young-old in rural, the young-old in urban were prone to live alone (ORs=1.61, P＜0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1＜ORs＜1.69, P＜0.05).Conclusions: The aged cohort in urban-rural distinction were facing an increasing need of immediate care due to the inadequate supports being provided, especially among rural elderly. The oldest old in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support and health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.

scholarly journals Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Pattaraporn Khongboon ◽  
Sathirakorn Pongpanich
Keyword(s):  
Informal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Socioeconomic Development ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Rural And Urban Areas ◽  
Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

scholarly journals URBAN-RURAL DISPARITY: THE UTILIZATION OF PRIMARY HEALTHCARE CENTERS AMONG ELDERLY IN EAST JAVA, INDONESIA

2019 ◽  
Vol 7 (2) ◽  
pp. 147 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono
Keyword(s):  
Primary Healthcare ◽  
Rural Areas ◽  
Health Research ◽  
Urban Areas ◽  
The Elderly ◽  
Utilization Of Health Services ◽  
Healthcare Center ◽  
Urban Rural ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center

Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient. 

Long-Term Care for Older Adults in ASEAN Plus Three: The Roles of Family, Community, and the State in Addressing Unmet Eldercare Needs

2018 ◽  
Vol 30 (10) ◽  
pp. 1499-1515 ◽  
Author(s):  
Wei-Jun Jean Yeung ◽  
Leng Leng Thang
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Long Term Care ◽  
Elderly Women ◽  
Unmet Need ◽  
Care Plan ◽  
Cultural Norms ◽  
Term Care ◽  
Home Based

Objective: To introduce this Special Issue that focuses on understanding the issues surrounding the long-term care (LTC) in selected societies in Southeast and East Asian countries. Method: We first provide demographic and socioeconomic context for these countries and then summarize the seven articles in this issue. Results: The articles highlight the rapidly rising demand for LTC in this region in the next few decades given the declining fertility, lengthening life expectancy, and increasing migration. They also discuss challenges and strategies in meeting these demands. Most countries are ill prepared to cope with the demand for LTC with older adults heavily rely upon female family members for care. Elderly women in low-income households have the greatest unmet need. Discussion: Home-based and community-based services are set to become an integral part of the LTC system. It is important to incorporate older adults’ cultural norms and wishes in their care plan and provision.

scholarly journals Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e022324 ◽  
Author(s):  
Yangyang Qian ◽  
Wen Qin ◽  
Chengchao Zhou ◽  
Dandan Ge ◽  
Li Zhang ◽  
...  
Keyword(s):  
Rural Areas ◽  
Living Arrangements ◽  
Urban Areas ◽  
Institutional Care ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Empty Nest ◽  
Care Needs ◽  
Term Care ◽  
The Government

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

scholarly journals Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China

2020 ◽  
Vol 12 (7) ◽  
pp. 2598 ◽  
Author(s):  
Liangwen Zhang ◽  
Sijia Fu ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
The Elderly ◽  
Severe Disabilities ◽  
Term Care ◽  
The Sustainable Development ◽  
Global Challenge ◽  
Disabled Elderly ◽  
Urban And Rural Areas ◽  
Care Costs

An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China.

scholarly journals Prediction the Contribution Rate of Long-Term Care Insurance for the Aged in China Based on the Balance of Supply and Demand

2020 ◽  
Vol 12 (8) ◽  
pp. 3144 ◽  
Author(s):  
Liangwen Zhang ◽  
Sijia Fu ◽  
Ya Fang
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Long Term Care ◽  
Population Census ◽  
Contribution Rate ◽  
Term Care ◽  
Disabled Elderly ◽  
Long Term Care Insurance ◽  
Per Capita

There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.

scholarly journals Age-Friendly Online Training Programs for Long-Term Services and Supports Staff to Improve Care for Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 532-532
Author(s):  
Linda Edelman ◽  
Kara Dassel
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Online Training ◽  
Team Leadership ◽  
Educational Opportunities ◽  
Opioid Use ◽  
Term Care

Abstract The purpose of our Geriatric Workforce Enhancement Program is to provide geriatric and primary care education and training to long-term care (LTC) providers and staff, health professions students and community members. Our LTC partners and the communities we serve are often very rural and travel to urban areas for training can be difficult. Therefore, we have developed four online training that are offered free to our partners and rural communities statewide. These programs are designed to integrate the aims of the Age-Friendly 4M’s model (i.e., What Matters, Mobility, Medication, Mentation). The LTC nurse residency program provides gerontological nursing and inter-professional leadership training (all 4M’s), in a synchronous online environment. The asynchronous Alzheimer’s Disease and Related Dementias training modules educate LTC staff and family caregivers about types, diagnosis and care of older adults with dementia (Mentation and Medication). The asynchronous Opioid Use in LTC modules were developed with partners to deliver live at LTC staff trainings about opioid stewardship (Medication). The LTC Learning Communities are monthly tele-health sessions for inter-professional LTC teams to discuss current issues and propose solutions (all 4M’s). We have successfully leveraged different synchronous and asynchronous online modalities to increase educational opportunities for formal and informal caregivers, including those in rural areas whose educational opportunities are geographically limited. To date our programs have reached over 500 individuals across our state, increasing knowledge about geriatric concepts, communication and team leadership. Moving forward, we will continue to develop and refine educational programs that promote the Age-Friendly geriatric-focused health care.

The Welfare Effects of Carbon Tax on Chinese Households: A Study Based on the 2013 Chip Survey Data

2021 ◽  
pp. 2050019
Author(s):  
LI Xuehui ◽  
LI Zhi ◽  
WANG Zhengxin
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Household Income ◽  
Urban Areas ◽  
Carbon Tax ◽  
Rural Households ◽  
High Income ◽  
Cyclic Utilization ◽  
Urban Rural ◽  
Low Income Households

Based on the micro-data from the 2013 Chinese Household Income Project (CHIP) Survey, the authors use a Quadratic Almost Ideal Demand System (QUAIDS) model to simulate and measure the impacts on the welfare of urban and rural households with different incomes after a carbon tax at 50[Formula: see text]RMB/ton was levied in China. The results show that the collection of carbon tax will increase households’ consumer spending to varying degrees. In urban areas, the carbon tax exerts the greatest impact on low-income households, followed by high-income households; while in rural areas, it has the most significant effects on high-income households and the least on low-income households. On the whole, carbon tax’s impact on urban households is greater than that on rural households. To a certain extent, it can help the household income inequality change for the better and narrow the urban–rural income gap. Since the carbon tax does not act on the distribution of Chinese household income in a simply regressive or progressive way, the authors believe that China should implement supporting policies such as tax subsidies or tax refund as supplements to carbon taxation in an effort to establish a mechanism for cyclic utilization of carbon tax revenue.

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