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Home-based healthcare service has gradually become the most important model to cope with aging in China. However, the contradiction between oversupply and insufficient demand of healthcare services is becoming increasingly serious. How to effectively improve the realized utilization of healthcare resources has become a key issue in the development of healthcare services. Based on the social background of “getting old before getting rich”, this article explores the relationship between economic accessibility and realized utilization, and finds that the impact of economic accessibility on realized utilization is inverted U-shaped, not a linear positive effect. In addition, considering the moderating role of family support, it is found that family support can strengthen the inverted U-shaped effect of economic accessibility on realized utilization. Therefore, exerting the role of family and improving economic accessibility can effectively solve the dilemma of low utilization of healthcare services.
Xiaodong Di; Lijian Wang; Liu Yang; Xiuliang Dai. Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China. Healthcare 2021, 9, 218 .
AMA StyleXiaodong Di, Lijian Wang, Liu Yang, Xiuliang Dai. Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China. Healthcare. 2021; 9 (2):218.
Chicago/Turabian StyleXiaodong Di; Lijian Wang; Liu Yang; Xiuliang Dai. 2021. "Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China." Healthcare 9, no. 2: 218.
Background While community care services have been developing rapidly as a new way to meet the growing demands of elderly individuals in China, their health benefits are virtually unknown. Thus, the aim of this study was to examine the Chinese elderly individuals’ utilisation of community care services and its association with the mental health with comparing rural-urban and gender differences. Methods For this 2019 cross-sectional study, 687 elderly people from 7 counties (districts) of China’s Shaanxi province were enrolled. Respondents’ mental health level was assessed using a self-reported mental health measure. Four categories of community care services utilisation were examined: daily care services, medical care services, social and recreational services and spiritual comfort services. The binary logistic regression model was used in examining the association between community care services utilisation and mental health. Results Our results showed that there was a noted difference in mental health level between the male and female groups. Utilisation of medical care services and social and recreational services was significantly higher in the rural group than that in the urban group. Regression analysis showed that utilisation of daily care services (β = 0.809, p = 0.008) and social and recreational service (β = 0.526, p = 0.035) was significantly and positively associated with elderly individuals’ mental health level. Specifically, daily care services utilisation predicted a better mental health of the rural elderly (β = 1.051, p = 0.036) and the male elderly (β = 1.133, p = 0.053), while social and recreational services utilisation predicted a better mental health of the urban elderly (β = 0.927, p = 0.008) and the female elderly (β = 0.864, p = 0.007). Conclusions Our findings indicated varied levels of community care services utilisation and mental health are common among the elderly people in China. Community care services utilisation has a positive, albeit selective, association with elderly individuals’ mental health. Further policies should strengthen the equitable development of high-quality community care services in urban and rural areas to improve the mental health of elderly individuals, and focus more on gender differences in terms of community care services needs.
Liu Yang; Lijian Wang; Xiuliang Dai. Rural-urban and gender differences in the association between community care services and elderly individuals’ mental health: a case from Shaanxi Province, China. BMC Health Services Research 2021, 21, 1 -12.
AMA StyleLiu Yang, Lijian Wang, Xiuliang Dai. Rural-urban and gender differences in the association between community care services and elderly individuals’ mental health: a case from Shaanxi Province, China. BMC Health Services Research. 2021; 21 (1):1-12.
Chicago/Turabian StyleLiu Yang; Lijian Wang; Xiuliang Dai. 2021. "Rural-urban and gender differences in the association between community care services and elderly individuals’ mental health: a case from Shaanxi Province, China." BMC Health Services Research 21, no. 1: 1-12.
There is little research on the utilization of non-medical community healthcare services among the elderly, compared with that of medical community healthcare services. From the perspective of both supply and demand, based on the survey data from Shaanxi province, this study examined supply-related factors (including service supply, service quality, service charge and service accessibility) and demand-related factors (including service need, individual financial status, family care support and knowledge of service) affecting the utilization of non-medical community healthcare services among the elderly in China by using Poisson regression. The findings show that service supply, service quality, service need and knowledge of service are positively associated with the utilization of non-medical community healthcare services among elderly Chinese, but the other factors identified in previous studies are not significant predictors for the utilization of the services among the elderly in the context of China. To our knowledge, this is the first study to examine both supply-related factors and demand-related factors affecting the utilization of non-medical community healthcare services among elderly Chinese.
Zhao Yu; Lijian Wang; Tolulope Ariyo. Supply and Demand-Related Decisive Factors in the Utilization of Non-Medical Community Healthcare Services among Elderly Chinese. International Journal of Environmental Research and Public Health 2020, 18, 228 .
AMA StyleZhao Yu, Lijian Wang, Tolulope Ariyo. Supply and Demand-Related Decisive Factors in the Utilization of Non-Medical Community Healthcare Services among Elderly Chinese. International Journal of Environmental Research and Public Health. 2020; 18 (1):228.
Chicago/Turabian StyleZhao Yu; Lijian Wang; Tolulope Ariyo. 2020. "Supply and Demand-Related Decisive Factors in the Utilization of Non-Medical Community Healthcare Services among Elderly Chinese." International Journal of Environmental Research and Public Health 18, no. 1: 228.
The current study investigated the association between three types of family support and living satisfaction of elderly individuals in China, and paid particular attention to the possible mediating role of the elderly population’s multidimensional health. A cross-sectional survey was conducted in 2019, and 938 elderly people from seven counties (districts) of China’s Shaanxi province were enrolled. Multivariable linear regression and mediation effect analysis were employed to examine the integrated relationships among these variables. The results showed that emotional support and decisional support from families were positively related to the living satisfaction of elderly individuals (β = 0.101, p = 0.000; β = 0.263, p = 0.000), while the relationship between daily living support and living satisfaction was not significant (β = 0.017, p > 0.05). The mediation examination further demonstrated that both mental state and social integration mediated the association between emotional support and living satisfaction, as well as the association between decisional support and living satisfaction, but a mediating effect of physical health was not observed. These results indicate the pathways in the relationships of different types of family support to living satisfaction via mental state and social integration, having significant implications for enhancing the living satisfaction the elderly.
Lijian Wang; Liu Yang; Xiaodong Di; Xiuliang Dai. Family Support, Multidimensional Health, and Living Satisfaction among the Elderly: A Case from Shaanxi Province, China. International Journal of Environmental Research and Public Health 2020, 17, 8434 .
AMA StyleLijian Wang, Liu Yang, Xiaodong Di, Xiuliang Dai. Family Support, Multidimensional Health, and Living Satisfaction among the Elderly: A Case from Shaanxi Province, China. International Journal of Environmental Research and Public Health. 2020; 17 (22):8434.
Chicago/Turabian StyleLijian Wang; Liu Yang; Xiaodong Di; Xiuliang Dai. 2020. "Family Support, Multidimensional Health, and Living Satisfaction among the Elderly: A Case from Shaanxi Province, China." International Journal of Environmental Research and Public Health 17, no. 22: 8434.
With the increase of the aging population and the lack of family care, home-based healthcare services have gradually become the main model to cope with aging, so local governments have invested heavily in the construction of home-based healthcare services. However, healthcare services still have problems such as low resource utilization and imbalanced development. The reason is that the supply and demand of healthcare services are not matched and the potential accessibility is low. Therefore, based on the supply and demand of healthcare services, this article pulls out the spatial and social factors that affect the potential accessibility, and tests the influence of individual factors on the potential accessibility among different groups of older adults. It is found that the perceived vulnerability of the older adults will reduce the potential accessibility of healthcare services. The psychosocial status, income and education level with the willingness to use healthcare services of the older adults are directly proportional, while residence has a negative impact on the potential accessibility. Finally, based on this finding, this article puts forward feasible suggestions from the perspective of policy content, publicity, and implementation.
Lijian Wang; Xiaodong Di; Liu Yang; Xiuliang Dai. Differences in the Potential Accessibility of Home-Based Healthcare Services among Different Groups of Older Adults: A Case from Shaanxi Province, China. Healthcare 2020, 8, 452 .
AMA StyleLijian Wang, Xiaodong Di, Liu Yang, Xiuliang Dai. Differences in the Potential Accessibility of Home-Based Healthcare Services among Different Groups of Older Adults: A Case from Shaanxi Province, China. Healthcare. 2020; 8 (4):452.
Chicago/Turabian StyleLijian Wang; Xiaodong Di; Liu Yang; Xiuliang Dai. 2020. "Differences in the Potential Accessibility of Home-Based Healthcare Services among Different Groups of Older Adults: A Case from Shaanxi Province, China." Healthcare 8, no. 4: 452.
With the rapid increase of the elderly population in China, healthcare services for the elderly have gradually become an important welfare resource. However, the healthcare service for the elderly still has problems such as mismatched supply and demand and unbalanced resources. In order to effectively eliminate the path barriers to match supply and demand, and improve the accessibility of healthcare services, this paper introduces the sustainability of the healthcare service based on the accessibility theory, and constructs an index system from the three dimensions of potential accessibility, realized accessibility, and sustainable accessibility of healthcare services for the elderly. Then, the paper makes a practice application of the index system based on survey data of healthcare services from Shaanxi province, China. Finally, the paper finds that the total accessibility and sustainable accessibility of healthcare services for the elderly in Shaanxi Province are at an average level. The score of potential accessibility is high, indicating that elderly people have greater opportunities to use healthcare services. The realized accessibility score is low, which indicates that the actual use of healthcare services for the elderly presents low satisfaction.
Xiaodong Di; Lijian Wang; Xiuliang Dai; Liu Yang. Assessing the Accessibility of Home-Based Healthcare Services for the Elderly: A Case from Shaanxi Province, China. International Journal of Environmental Research and Public Health 2020, 17, 7168 .
AMA StyleXiaodong Di, Lijian Wang, Xiuliang Dai, Liu Yang. Assessing the Accessibility of Home-Based Healthcare Services for the Elderly: A Case from Shaanxi Province, China. International Journal of Environmental Research and Public Health. 2020; 17 (19):7168.
Chicago/Turabian StyleXiaodong Di; Lijian Wang; Xiuliang Dai; Liu Yang. 2020. "Assessing the Accessibility of Home-Based Healthcare Services for the Elderly: A Case from Shaanxi Province, China." International Journal of Environmental Research and Public Health 17, no. 19: 7168.
Objective: China’s targeted poverty alleviation policy has a profound impact on the country’s rural economic and social development now. This study aimed to learn about the health status and health equity of rural poor residents under the implementation of the policy. It further explores the factors affecting the health status and health equity of rural poor residents in order to contribute to the improvement of the policy. Methods: The data of 1233 rural poor residents were collected from a questionnaire survey from 12 prefecture-level cities and areas of Shaanxi province in 2017, and the self-reported health was used to reflect the health status. A concentration index was applied to measure the inequity of the health status of rural poor residents. The decomposition method was employed to explore the source of health inequity. Results: The results showed that 44.56% of rural poor residents in Shaanxi province had a poor or very poor health status, which was affected by their economic level, gender, age, degree of education, and marital status. Additionally, participation in agricultural industry development, relocation, health poverty alleviation, and basic living standards were significantly correlated with health status. The concentration index of the health status of rural poor residents was 0.0327. The primary contributors to the health inequity in different regions varied, but the economic level and the degree of education were the most significant factors, and the targeted poverty alleviation policy had a significant impact on health equity. Conclusions: The results indicated that the health status of rural poor residents in Shaanxi province was generally poor, there was a pro-rich inequity in the health status, and the degree of education and economic level were the primary factors affecting the health status and health equity. The targeted poverty alleviation policy greatly impacted the health status and health equity of rural poor residents, and the difference in health status would lead to the inequity of benefits of the targeted poverty alleviation policy. In the future, the policy should focus on ensuring the sustainable development ability of rural residents with poor health status.
Xiuliang Dai; Lijian Wang; Yangling Ren. The Effects of China’s Targeted Poverty Alleviation Policy on the Health and Health Equity of Rural Poor Residents: Evidence from Shaanxi Province. Healthcare 2020, 8, 256 .
AMA StyleXiuliang Dai, Lijian Wang, Yangling Ren. The Effects of China’s Targeted Poverty Alleviation Policy on the Health and Health Equity of Rural Poor Residents: Evidence from Shaanxi Province. Healthcare. 2020; 8 (3):256.
Chicago/Turabian StyleXiuliang Dai; Lijian Wang; Yangling Ren. 2020. "The Effects of China’s Targeted Poverty Alleviation Policy on the Health and Health Equity of Rural Poor Residents: Evidence from Shaanxi Province." Healthcare 8, no. 3: 256.
The most populous country in the world, China needs more health care. Shenmu's practices show that National Free Health Care (NFHC) system has played an active role in fulfilling the citizen's needs of health care, and alleviating the difficulties in affording the medical costs and seeing doctors. But NFHC system needs substantial financial supporting. It is worth in-depth discussing and reflecting on whether the NFHC system suits China's national conditions. The paper establishes the population age structure forecasting model and NFHC financial burden model by decomposition methodology and actuarial modelling. And it finds than the financial burden of NFHC system in Shenmu will be increased from 256.64 million Yuan to 656.04 million Yuan in 2013-2020, with the growth rate 12.45%. Meanwhile, the percentage of the financial burden in government's annual revenue is less than 2% in 2013-2020, NFHC system has financial sustainability in Shenmu. According to the successful experience abroad and the calculated results in Shenmu, to extend the NFHC system to the whole of China has financial sustainability and realistic possibility.
Lijian Wang. Does the ``National Free Health Care'' have financial sustainability in China? A case of Shenmu County, Shaanxi Province, China. Technology and Health Care 2015, 23, S15 -S19.
AMA StyleLijian Wang. Does the ``National Free Health Care'' have financial sustainability in China? A case of Shenmu County, Shaanxi Province, China. Technology and Health Care. 2015; 23 (s1):S15-S19.
Chicago/Turabian StyleLijian Wang. 2015. "Does the ``National Free Health Care'' have financial sustainability in China? A case of Shenmu County, Shaanxi Province, China." Technology and Health Care 23, no. s1: S15-S19.
Considering the rapid growth of China’s elderly rural population, establishing both an adequate and a financially sustainable rural pension system is a major challenge. Focusing on financial sustainability, this article defines this concept of financial sustainability before constructing sound actuarial models for China’s rural pension system. Based on these models and statistical data, the analysis finds that the rural pension funding gap should rise from 97.80 billion Yuan in 2014 to 3062.31 billion Yuan in 2049, which represents an annual growth rate of 10.34%. This implies that, as it stands, the rural pension system in China is not financially sustainable. Finally, the article explains how this problem could be fixed through policy recommendations based on recent international experiences.
Lijian Wang; Daniel Béland. Assessing the Financial Sustainability of China’s Rural Pension System. Sustainability 2014, 6, 3271 -3290.
AMA StyleLijian Wang, Daniel Béland. Assessing the Financial Sustainability of China’s Rural Pension System. Sustainability. 2014; 6 (6):3271-3290.
Chicago/Turabian StyleLijian Wang; Daniel Béland. 2014. "Assessing the Financial Sustainability of China’s Rural Pension System." Sustainability 6, no. 6: 3271-3290.
Lijian Wang; Daniel Béland; Sifeng Zhang. Pension fairness in China. China Economic Review 2014, 28, 25 -36.
AMA StyleLijian Wang, Daniel Béland, Sifeng Zhang. Pension fairness in China. China Economic Review. 2014; 28 ():25-36.
Chicago/Turabian StyleLijian Wang; Daniel Béland; Sifeng Zhang. 2014. "Pension fairness in China." China Economic Review 28, no. : 25-36.
The new type rural social endowment insurance system is one of the important policy arrangements in public welfare field in China. Quantitative research is theoretically and practically important for studying the new type rural social endowment insurance system. In this paper, based on the modern control theory, the linear control model for the new type rural social endowment insurance system is set up, and then the robust stability for the new type rural social endowment insurance system of China with minor fluctuations is discussed by using the linear control model.
Lijian Wang. Robust Stability Analysis for the New Type Rural Social Endowment Insurance System with Minor Fluctuations in China. Discrete Dynamics in Nature and Society 2012, 2012, 1 -9.
AMA StyleLijian Wang. Robust Stability Analysis for the New Type Rural Social Endowment Insurance System with Minor Fluctuations in China. Discrete Dynamics in Nature and Society. 2012; 2012 ():1-9.
Chicago/Turabian StyleLijian Wang. 2012. "Robust Stability Analysis for the New Type Rural Social Endowment Insurance System with Minor Fluctuations in China." Discrete Dynamics in Nature and Society 2012, no. : 1-9.