An industry in the making: the emergence of institutional elder care in urban china.
An industry in the making: the emergence of institutional elder care in urban china.
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DOI：
10.1111/j.1532-5415.2011.03330.x
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发表时间：
2011-04
影响因子：
6.3
通讯作者：
Mor V
中科院分区：
文献类型：
--
作者：
Feng Z;Zhan HJ;Feng X;Liu C;Sun M;Mor V
中国人口结构的变化给快速增长的老年人口的护理带来了前所未有的挑战。零星的报道表明，机构养老在中国最近出现，但目前对这一现象知之甚少。本研究使用2009年从中国南京收集的调查数据，并辅以来自其他七个主要城市的政府登记数据，记录了老年护理机构的增长、所有权、融资、人员配备和居民特征。在这些城市运营的设施中，有一半至三分之二是在过去十年中建立的，主要是非政府部门。在南京，1990年之前建造的房屋中政府所有权占主导地位（96%），但在20世纪90年代（60%）和21世纪初（23%）越来越少，其他七个城市也观察到了这种模式。在南京，平均每个家庭的日常运营收入的80%以上来自私人支付或其他非政府来源，并且这一比例随着设施的建立而急剧增加。大多数（85%）非政府拥有的住房正在从政府获得持续的每张床位补贴。大多数研究机构缺乏临床工作人员;大多数护理人员是农村移徙工人。在功能依赖和敏锐度水平方面，居民的病例组合在各设施之间存在相当大的差异。这些发现描绘了中国城市机构长期护理的新兴行业的出现和快速增长，以及机构所有权，融资和客户的根本转变。
Demographic shifts in China pose unprecedented challenges in the care of a rapidly growing older population. Sporadic reports suggest the recent emergence of institutional elder care in China, but little is currently known about this phenomenon. This study documents the growth, ownership, financing, staffing, and resident characteristics of elder care institutions using survey data collected in 2009 from Nanjing, China, supplemented with government registry data from seven additional major Chinese cities. Between one-half and two-thirds of facilities operating in these cities were founded in the last decade, primarily in the non-government sector. In Nanjing, government ownership dominated homes built before 1990 (96%) but was increasingly rare in the 1990s (60%) and in the 2000s (23%), a pattern observed in the other seven cities as well. In Nanjing, the average home now draws more than 80% of its daily operating revenues from private-pay or other non-government sources, and this share increases sharply with the recency of facility establishment. The majority (85%) of non-government-owned homes are receiving ongoing per-bed subsidies from the government. The lack of clinical staff characterizes the majority of study facilities; most care staff are rural migratory workers. There is considerable variability across facilities in the case-mix of residents in terms of functional dependence and acuity levels. These findings portray the emergence and rapid growth of a nascent industry of institutional long-term care in urban China and a fundamental shift in institutional ownership, financing, and clientele.