The Emergence of Institutional Elder Care in China

描述（申请人提供）：近年来，中国各大城市的养老机构发展迅速。这一新的发展是为了应对中国老年人对正规长期护理（LTC）日益增长的需求。然而，目前对这些机构的组织、结构、资金来源和居民特征了解甚少。这些基本信息对于了解推动正规养老服务发展的社会、文化和市场力量至关重要。在这个项目中，来自中美两国经验丰富的LTC研究团队提议研究中国机构养老领域的最新发展。基于他们在美国和中国研究机构LTC系统的专业知识和经验，研究团队将开发一种养老院数据收集工具，可以在全国范围内方便地使用。利用该工具，通过结构化调查，从中国两个主要城市：天津和南京的老年护理院的代表性样本中收集了设施层面的组织属性和总体居民特征的系统定量数据。将与设施管理人员进行焦点小组讨论，以确保调查工具在最后确定之前是适当的，并与老年居民及其家庭成员进行焦点小组讨论，以便从质量上了解机构护理的文化意义。通过对每个城市的养老院样本进行深入研究，本项目试图提供一个全面的组织和居民特征的概况。从本研究中获得的见解将丰富面对社会养老变化的中国传统文化和家庭规范的理论认识。研究结果还将告知机构LTC服务的潜在消费者以及对该领域的政策制定、规划和法规感兴趣的政府机构。这个合作项目是互惠互利的，为加强中美两国大学之间的伙伴关系和促进学者之间的智力交流提供了一个很好的机会。从长远来看，研究小组计划以该项目的经验和发现为基础，在多个城市或全国范围内继续和扩大这一研究领域，最终将有助于形成一个可行的长期医疗服务体系，以满足中国即将到来的快速老龄化人口的需求。作为美国国立卫生研究院的延伸，这项研究将主要在中国与南开大学（天津）的关鑫平和南京大学（南京）的冯晓天合作完成。公共卫生启示：中国人口正在迅速老龄化，作为一项政策，机构长期护理的压力越来越大。这项合作研究将开发和测试对中国两个城市养老院的调查，以记录中国此类设施的发展和特点。

DESCRIPTION (provided by applicant): There has been a rapid growth of elder care institutions across major Chinese cities in recent years. This new development is in response to rising consumer demands for formal long-term care (LTC) for the elderly in China. Yet little is currently known about these institutions, their organization, structure, financing and residents' characteristics. Such basic information is essential to understand the social, cultural and market forces driving the development of formal elder care services. In this project, a team of experienced LTC researchers from the U.S. and China propose to study the recent developments in the institutional elder care sector in China. Building upon their expertise and experience studying the institutional LTC system in both the U.S. and China, the study team will develop a nursing home data collection instrument that can be readily used by others throughout the country. Using this instrument through structured surveys, systematic quantitative data at the facility-level on the organizational attributes and aggregated resident characteristics will be collected from a representative sample of elder care homes in two major cities in China: Tianjin and Nanjing. Focus group discussions will be conducted with facility administrators to insure adequacy of the survey instrument before it is finalized, and with elderly residents and their family members for a qualitative understanding of the cultural meanings of institutional care. Through a thorough study of the sampled elder care homes in each city, this project seeks to provide a comprehensive profile of their organizational and residents' characteristics. Insights gained from this study will enrich a theoretical understanding of traditional Chinese culture and family norms in the face of social changes in elder care. Research findings will also inform potential consumers of institutional LTC services and government agencies interested in policy making, planning and regulations in this area. This collaborative project is mutually beneficial and provides a great opportunity to strengthen the partnership relationship and promote intellectual exchanges among scholars from the participating U.S. and Chinese universities. In the long term, the study team plans to build on experiences and findings from this project to continue and expand this line of research in multiple cities or at the national level, which ultimately will contribute to shaping a viable LTC system to meet the impending demand of a fast aging population in China. This research will be done primarily in China in collaboration with Xinping Guan at Nankai University (in Tianjin) and with Xiaotian Feng at Nanjing University (in Nanjing), as an extension of NIH. PUBLIC HEALTH REVELANCE: China's population is aging rapidly and pressures are building to grow institutional long term care as a policy. This collaborative study will develop and test a survey of nursing homes in two Chinese cities to document the growth and character of such facilities in China.