Journal of the American Medical Directors Association
Long-Term Care Around the GlobeThe “Leap Forward” in Nursing Home Development in Urban China: Future Policy Directions
Section snippets
Decline of the Traditional Social Contract for Elder Care Provision
As a Confucian society, the principle of filial piety has long been cornerstone of elder care provision in China.9, 10 While family members assume responsibility for providing care for their ill and frail elderly parents at home, state social welfare institutions only provide care for destitute older persons who fall into the categories of the “3 no's” (those without family support, source of income, and unable to work) in urban areas11 or “5 guarantees” (those requiring government guarantee of
Policy Initiatives for a New Social Contract and Its Objective to “Leap Forward” Residential Home Beds
While the traditional social contract has been eroded, modernization and marketization also have driven welfare reform and the formation of a new social contract. Social welfare socialization since the 1980s allowed state social welfare institutions to admit older persons who can pay service charges. After the 1990s, further decentralization of rights and responsibilities extended the provision of residential care services from state to non-government organizations, individual and private
Three Promising Policy Directions to Better Foster a New Social Contract in Contemporary China
The recent LPRIE (2012), Permission Rule (2013), and Administration Rule (2013) indicate the Chinese government's commitment to build a comprehensive system regulating residential care facilities. These rules, though, are written in general and broad terms, and require the Chinese authorities to further enact supplementary rules to standardize the provision and quality of residential care homes and to fill the gap for actual implementation.34, 35 Until new supplementary rules are enacted, “2
Conclusion
In 2013, the Chinese government adopted the policy objective to reach a ratio of 30:1000 residential care beds in 2015. This “leap-forward” development goal now faces problems of both low occupacy and failure to meet the needs of older care recipients. We have identified 3 possible policy directions that could enhance the Chinese LTC system. The first is to estabish national eligibility criteria for LTC. Besides considering age, means, and needs, it is strongly suggested to include
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2021, Geriatric NursingCitation Excerpt :The turnover rate of employees in nursing homes is high and contributes to cost increases and staffing shortages16. The low staff to resident ratio, widely reported, leads to suboptimal care for residents in Chinese nursing homes.6,17 However, the relationship between staffing levels and quality of care remains unclear, and the Chinese government has made little progress in establishing optimal nursing home staffing levels, which could negatively affect the quality of care provided.17
The authors declare no conflicts of interest.