Community Aged Care Service Multi-subject Participation Mechanism Research In Shanghai

With aggravation of aging population and degree in shanghai,institution endowment resources become more shortage,most of elderly accept care services at home or in the community,the change of “4+2+1”family structure and nursing professional make family have no time or ability to care elderly.Under such a social background,the demand of community elderly care service increases,multi-subjects participating in community elderly care services is also a necessary trend.This thesis takes three testing area in Shanghai as the research subject with detailed studies on multi-subject participation model and related empirical examination.This investigation provides theoretical foundation and data support for the establishment of sound elderly care system in the future,and has great theoretical and practical value.The first part of this thesis starts with three elements(service subjects,coordination processes,and cooperation/protection)and processes(preparation,implementation,and feedback)of multi-subject elderly care service in Shanghai community,and investigates the multi-subject participation model,on the basis of which a preliminary structural diagram is built.The second part is based on empirical studies on elderly care service at Pudong New District,which has the highest aging degree among the three districts in the first trial batch in Shanghai,and investigates factors influencing the performance of multi-subject participation and cooperation from two research angles.The first of research angles,search for factors influencing multi-subject participation performance — “satisfaction degree of the aged ” — through the application of customer satisfaction index model and structural equation analysis.The main research results: 1.The dependable variable of “satisfaction degree of the aged ” has construct validity with the variables of perceived quality,perceived value,expectation in the structural equation model based on 356 effective surveys.2.Structural equation associated path revealed,the elderly care service in Pudong New District started in 2013 is affected by four facts:(1)Perceived value,perceived quality,and expectation all influences satisfaction degree but with decreasing order;(2)Perceived value and perceived quality have positive influence on the satisfaction degree but expectation has negative impact on it;(3)Perceived quality has positive influence on perceived value but expectation has negative impact on perceived quality;(4)Perceived quality is affected by five elements or steps(participation subjects,care service application process,application evaluation process,care process,and protection measure),participation subjects and care process have the biggest impact on perceived quality.The second of research angles,application of regression analysis method to identify elements influencing the performance of multi-subject cooperation.Our studies show that 1.The analysis is based on 110 effective surveys from several departments in government,medical institutions in communities(community health centers or community nursing stations),and third-party evaluation agencies etc.2.The regression analysis concludes that(1)Relationship cognition correlates with relationship quality,and relationship quality correlates with cooperation performance;(2)Relationship quality serves as a medium between relationship cognition and cooperation performance;(3)External environment has unneglectable regulating effect on relationship cognition and relationship quality.In the final part of this thesis,we propose three measures to improve the multi-subject participation model: 1.Paying attention to factors influencing the performance of multi-subject participation care service is an effective way to improve the satisfaction degree of the aged.(1)It is necessary to improve the five factors or processes that affect the perceived quality of aged population;(2)On the premise of a fixed price or fixed service quality,it is needed to improve the service or reduce the price respectively to satisfy the perceived value of the aged population.2.Since relationship cognition,relationship quality,and external environment are key variables affects the performance of multi-subject participation care service,it is essential to improve the positive correlation among these elements,make use of the medium role of relationship quality,and take advantage of the regulating effect of external environment.3.Improving the third-party supervision,evaluation,and feedback model in the trial areas,and encourage volunteers to participate in the elderly care service.