Research On The Coupled Medical-nursing Care Mode For The Disabled Elderly In China

The social service development statistics bulletin of 2016 showed that the population over 60 years old was 230860000,accounting for 16.7%in China.The same year,?the fourth sample survey of the living conditions of the elderly in urban and rural areas in China?showed that fully-disabled and half-disabled elderly accounted for 18.3%of the aged.Under the background of Chinese aging,with the characteristic of high proportion,large number and poor health status of old people,the problem of taking care of disabled elderly has become increasingly serious and has taken center stage in nation,society,family and individual.A comprehensive research indicates that the existing modes in China,including home care,community care and institutional endowment,have not been able to solve the issue of care for disabled elderly effectively.Exploring new mode has become an urgent project for social science in recent years.Coupling is the concept of Physics,that is,the dynamic relationship of mutual dependence,coordination and promotion in the virtuous interaction of the subsystems.In order to have synergistic effect,we have transplanted this concept into the study to explore the coupled medical-nursing care mode for the disabled elderly.This study analyzes the aging market of disabled elderly from the perspective of coupling.Combing with national condition and extraordinary demand of disabled elderly,we try to construct the multi-leveled system of social service for the disabled elderly,learning lessons from developed countries and regions.To reach the goals consisted of improving the quality of life effectively,providing theoretical guidance and basis of decision-making for application of pension policy,the system,that is composed of home care,community care and institutional endowment,should be consistent with the social-economic development and social security system.To achieve the goal,"why do we study this problem?" and "What are the bases for the study?" are firstly answered.Then,"what is the problem now" is analyzed from the perspective of demand and supply,with the combination of theoretical and empirical method,considering national conditions and experience from developed countries and regions.Finally,we try to answer the question "how to solve the problem".The first chapter is the introduction,including background and significance of the research,domestic and overseas status,research methods,and innovation points.The characteristics of Chinese aging include increasing number of disabled elderly,rising demand of pension,and insufficient supply of institution.Exploring the coupled medical-nursing care mode for disabled elderly,is not only suitable for physical and mental condition of disabled elderly,but also consistent with national condition and traditional culture,which is a vital social research program with important theoretical and practical value.The second chapter is the definition of core concepts and theoretical basis.Disabled elderly,medical-nursing care,coupling mode are clearly elaborated.Furthermore,we analyze the research program on the basis of synergy theory,welfare pluralism,stakeholder theory,demand hierarchy theory and social support theory.The third chapter elaborates the evolution of endowment mode in China.The generation and development of pension system has had a profound historical and social root.The thesis is trying to make a probe into the course of evolution to investigate related factors and interactive mechanism of the mode change in a historical perspective.It is contributed to deepening the understanding of "respecting the elderly" from its birth 5000 years ago to today's prosperity.The fourth chapter casts light upon the relationship between demand of disabled elderly and mode of medical-nursing care.The similarities and heterogeneities among disabled and self-care elderly,medical-nursing care mode and traditional mode are studied.Combining with SWOT analysis,we draw the conclusion that,disabled elderly is the focus of medical-nursing care.Furthermore,medical-nursing model is one of the best choices for disabled elderly.The fifth chapter makes comparisons and experience learned from developed countries and regions.Through the detailed description of PACE program in America,British community care,Japanese care insurance and ten year plan of long-term care in Chinese Taiwan,it would provide reference for building the coupling mode of medical-nursing care for the disabled elderly.The sixth chapter is the research on the characteristics and influencing factors of activity of daily living in China.Twenty indicators of three categories are selected out of Chinese Longitudinal Healthy Longevity Survey,including basic information,behavior feature and health status.Descriptive analysis,interactive analysis and Logistic regression are adopted to thoroughly understand the disabled status of Chinese elderly and identify high-risk factors and groups of disability.The seventh chapter is an empirical study on the willingness of the disabled elderly in China.Through the combination of the first hand data in Jiangsu Province and second-hand data from CLHLS database,we summarize paticular demand of disabled elderly and important factors influencing their willingness,so as to lay the foundation for constructing the medical-nursing care mode in line with needs of disabled elderly.The eighth chapter deals with supply-side problems of medical-nursing service for disabled elderly.Through interviews and case studies,this chapter clarifies supply problems of home care,community care and institutional endowment,and traces the reasons based on grounded theory,laying the groundwork for supply-side reform for caring of the disabled elderly.The ninth chapter is the research on the path of the medical-nursing care mode for the disabled elderly.Based on the above theoretical and empirical research,we try to construct the coupled medical-nursing care mode which can promote the harmonious development of population,economy,society and environment.Suggestions for pension system reform are put forward to promote the optimization and sustainable development of medical-nursing care mode.The tenth chapter is the conclusion and outlook combs the main results of the paper and looks forward to the direction for further research.The study indicates that resource integration is the optimal path to deal with caring for disabled elderly.Hence,we should pay special attention to coupling system of the demand,supply and environment.To realize functional coupling,we should focus on establishment of cognition and collaborative mechanism.Furthermore,it is entirely indispensable to forge a service chain as well as strict assessment to ensure the fully coupled system.In addition,integration of policy and building modern filial piety are contributed to final goal.