| Objective:Investigate the current situation and problems of the resource allocation of nursing homes in Shanxi Province from the two aspects of supply and demand,and provide a reference for actively responding to the problem of population aging.1.Understand the current situation of resource allocation of nursing homes in Shanxi Province,and qualitatively analyze the current situation and existing problems of resource allocation of nursing homes.2.Analyze the occupational status and influencing factors of the main nursing staff in nursing homes.3.Analyze the care needs of the elderly in nursing homes and provide a basis for the organizations to improve the content of the elderly care services.4.Evaluate the resource allocation efficiency of nursing homes in Shanxi Province,and put forward suggestions for optimizing the allocation of institutional retirement resources and scientific and reasonable utilization.Methods:1.Analysis of the current situation of resource allocation and supply of nursing homes based on the results of field surveys,a descriptive analysis of the basic situation,human resources allocation,material resources allocation,and financial allocation of 13 nursing homes is carried out.Using the semi-structured interview method,selecting 12 heads of institutions as interview subjects,using grounded theory three-level coding to understand the current status and existing problems of resource allocation in nursing homes from a qualitative research perspective.2.Analysis on the supply status of nursing staff in nursing homes.The main nursing staff in nursing homes--nursing staff used Minnesota Satisfaction Questionnaire to investigate their job satisfaction,analyze the influencing factors of nursing staff’s job satisfaction,and find that the existing problems of the current nursing staff team.3.Analysis of the care needs of the elderly in nursing homes.With the help of an assessment tool—Care Dependency Scale(GDS),the degree of care dependence of the elderly in nursing homes is evaluated,which reflects the current status of the care needs of the elderly in nursing homes,and use multiple linear regression methods to analyze its influencing factors,grasps the unsatisfied care needs of the elderly,and provides a basis for institutions to improve the service content of the elderly care supply.4.Analysis on the efficiency of resource allocation of nursing homes.The data envelopment analysis model is used to measure the efficiency of resource allocation of nursing homes,analyze the current technical efficiency,pure technical efficiency and scale efficiency of nursing homes,and discuss the current status and problems of the current nursing homes.Improve the direction,optimize and perfect the resource allocation and scientific and rational utilization of institutional elderly care resources,and promote the development of institutional elderly care services.Results:1.According to the results of in-depth interviews,28 initial research categories,7main categories and 2 core categories are obtained through the grounded theory three-level coding analysis:(1)the current situation of the operation and configuration of the nursing homes;(2)the current problems in nursing homes.The status quo of operational configuration includes hardware facilities,staffing,and service content;the current problems of nursing homes include the factors of elderly care service personnel,the operation of the medical and elderly care system,the quality and ability of institutional services,and policy implementation factors.2.The overall job satisfaction items of the nurses surveyed in this study are averagely divided into(3.74±0.39)points,which is at a medium level;among them,5.33% of the nurses have low job satisfaction,78.69% of the nurses have medium job satisfaction,and15.98% Of caregivers have high job satisfaction.The results of univariate analysis showed that there were statistically significant differences in the scores of age,education level,employment method,pension insurance,medical insurance,daily working hours,and the status of senior care workers’ certificates(P<0.05);but gender There were no statistically significant differences in the scores of,marital status,monthly income,whether or not to participate in induction training,working years,and the number of elderly nursing at daily work(P>0.05).The results of multiple stepwise regression analysis showed that education level,employment methods,the existence of pension insurance,and the status of nursing care workers’ certificates were the main influencing factors of the job satisfaction of nursing staff in nursing homes(P<0.05).3.The total score of care dependence for elderly residents in nursing homes is(54.16±15.48),which is at a medium level of dependence.81.8% of elderly residents are dependent on care.The main care needs,that is,the 5 items after the scores of care needs are learning ability(2.32±1.17)points,recreational activities(2.50±1.17)points,values and rule awareness(2.94±1.33)points,daily life(2.98±1.1.39)points,social(3.23±1.40)points.The results of univariate analysis showed that there were statistically significant differences in the scores of age,education level,marital status,pension insurance,children’s visit frequency,monthly income,self-rated health status,and the number of chronic diseases(P<0.05);but gender There were no statistically significant differences in the scores of,medical security,number of children,length of stay,and type of living room(P>0.05).The results of multiple stepwise regression analysis showed that age,education level,frequency of children’s visits,monthly income,and number of chronic diseases were the main influencing factors for the elderly’s care-dependent(P<0.05).4.Among the 13 nursing homes,there are 3 nursing homes with effective comprehensive efficiency,and their pure technical efficiency and scale efficiency are both1,and they are in a state of constant return to scale;among the 10 nursing homes with ineffective comprehensive efficiency,pure technical There are 6 effective nursing homes,and the technical efficiency and scale efficiency of the other 4 nursing homes are in an invalid state.Of the 4 invalid institutions,3 are in a state of increasing returns to scale,and one is in a state of diminishing returns to scale.Conclusion:The application of supply-side reform to the institutional elderly care service industry is to achieve the coordination and balance between the supply capacity of nursing homes and the demand for elderly care.1.From the perspective of the overall supply of nursing homes,more than half of the nursing homes have a bed utilization rate below 60%,and the overall bed utilization rate of homes is not high.In terms of funds,the six nursing homes all suffered operating losses to a certain extent.The resource allocation situation of 13 nursing homes in Shanxi Province is that there is a serious shortage of elderly service talents,and the overall quality is low;the elderly care market lacks a perfect operation mechanism for the integration of medical and elderly care;the service quality of the elderly care institutions is uneven,and service capabilities need to be improved;Policy advocacy is more,but the actual investment and landing effect are not good.2.From the perspective of the supply of caregivers in nursing homes,the overall qualification certification rate of elderly care institutions reached 68%.Caregivers’ job satisfaction is at a medium level.They have the lowest level of satisfaction with institutional managers’ ability,institutional policy implementation,salary and workload,and job recognition.The survey found that nursing staff generally report low income,heavy workload,and salary.It is not equal to the workload,the professional social status is low,and the social recognition is low.Numerous factors such as the education level of the nursing staff,the way of hiring,the availability of pension insurance,and the status of the certificate will affect the job satisfaction of the nursing staff.The government and society should pay more attention to the industry of elderly care workers,improve the social status of the industry,increase the salary,vocational training and job benefits of care workers,pay attention to the pension security issues after retirement of the care workers,and solve the problem of nursing care for the worries of the employees,we will build a team of caregivers with higher quality to satisfy the elderly.3.From the perspective of the needs of the elderly,81.8% of elderly residents in nursing homes are dependent on care.The main care needs of the elderly who are dependent on care are learning ability,recreational activities,awareness of values and rules,daily life and social interaction.Nursing dependence is affected by many factors such as age,education level,frequency of children’s visits,monthly income,and number of chronic diseases.Nursing homes should strengthen the connotation of providing elderly care services,take care of the elderly as a starting point,focus on unmet needs,improve and enhance the service content and supply quality of nursing homes,and face the differentiated and diversified care needs of the elderly,to formulate suitable personalized management plans for the elderly,and provide accurate elderly care supply services.4.From the perspective of the resource allocation efficiency of nursing homes,it is found that the overall efficiency of 13 elderly care institutions in Shanxi Province is generally low,and the management level,personnel service capabilities,and the scale of the institutions need to be improved.The scale efficiency problem is significant,and the investment is insufficient and redundant.The rest coexist,each accounting for 50%.Some homes need to expand their scale to improve efficiency,and some homes need to reduce their scale and increase resource utilization to increase efficiency.The overall resource allocation of nursing homes is uneven,which is manifested in the inefficient use of beds and personnel resources.To sum up,with the continuous deepening and advancement of supply-side reforms,there is a large room for development of nursing homes.Homes need to start from the needs of precise care,develop diversified elderly care service supply methods,and provide high-quality elderly care services for the elderly to ensure the balance of supply and demand for elderly care services.The government should expand the elderly care market,innovate the development model of elderly care services,actively introduce private capital,and all departments jointly solve the practical difficulties in the operation of nursing homes,reduce the operational burden of the institutions,simplify the procedures of the institutions,and ensure that the policy documents can be implemented in nursing homes to fulfill the government’s due responsibilities.Only when the government and society work together to solve the actual problems can we promote the steady improvement of our province and even our country’s nursing homes and provide a high-quality platform for the elderly to enjoy their old age. |
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