Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers

BMC Geriatrics - Tập 23 - Trang 1-13 - 2023
Caiyun Qi1, Yuan Wang2, Xiaonan Qi3, Yunhe Jiao2, Chuanqi Que4, Yufei Chen2
1Department of social work, Shandong University, Jinan, China
2Department of labor and social security, Jilin University, Changchun, China
3Department of management, School of applied technology and health industries, Anshan Normal University, Anshan, China
4Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China

Tóm tắt

Due to the increasingly aging population in China and the changes in social and family structure, older adults’ care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers. In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers’ daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis. We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies’ excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm. We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.

Tài liệu tham khảo

UN. World population ageing 2019. New York. USA: United Nations, Department of Economic & Social Affairs; 2020.

Zhu HL. On the smart reconstruction China’s pension model. Soc Sci Front. 2020;4:231–6.

State Statistical Bureau. Available at: http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/qgrkpcgb/202106/t20210628_1818824.html [Accessed 2 May [Accessed 2 May 2022].022]

Chou ZJ. Study on the differences of family structure and pension problems of urban and rural elderly population in China. Hubei Soc Sci. 2018;7:46–52.

Wang ZF. Supply demand evaluation and development countermeasures of “Internet + aged Care” mode. Acad J Zhongzhou. 2020;3:81–6.

Misoch S. AAL: ambient assisted living assistive technologies for healthy ageing and opportunities for medicine and caring. Ther Umsch. 2015;72(9):561–5.

Anderson JG. Social, ethical and legal barriers to e-health. Int J Med Inform. 2007;76(5–6):480–83.

Fuchsberger V. Ambient assisted living: elderly people’s needs and how to face them//Proceedings of the 1st ACM international workshop on Semantic ambient media experiences. 2008: 21 – 4.

Wang ZB, Wu XL. Research on the service mode of urban community home-based elderly care — taking Wuhan as an example. Theory Mon. 2017;10:146–52.

Wang ZB. Service improvement of the urban home-based services for the elderly. J Xinjiang Univ (Philosophy Humanities & Social Sciences). 2017;45(6):38–45.

Wen HH, Wang YH. Analysis on the demand of ‘Internet+” home-based community care service based on individual difference theory. Soc Secur Stud. 2019;2:40–8.

Sui DC, Peng QC. Developing smart home-based elderly care service for China’s urban communities in the Internet Plus Context. J Xinjiang Norm Univ (Chinese Edition of Philosophy and Social Sciences). 2018;39(3):119–28.

Xu X. Resource shortage or resource dependence: resource dilemma of elderly care service in smart community. Lanzhou Acad J. 2019;39(5):196–208.

Hu XF. Center with medical care services — based on the practice of W City. Health Econ Res. 2020;37(11):11–4.

Zhu LH, Yang Q. Analysis on the supply, demand and media of intelligent elderly care services — based on the theory of “service chain. Chin J Gerontol. 2021;41(18):4118–24.

Jia YJ, Wang C. The construction of demand-oriented smart home care service system. Inn Mongolia Soc Sci. 2020;41(5):166–72.

Huang HH, Zhou KJ, Cao SM, et al. Establishment and practice of smart aged care platform based on hybrid aware model. Chin J Nurs. 2021;56(3):421–6.

Du XZ, Sun JN. The advantage, risk and path of the development of virtual nursing home. J Shanghai Adm Inst. 2020;21(04):74–85.

Qu Z. Getting rid of operation difficulties of Internet Plus Community Pension. Chongqing Soc Sci. 2017; (5): 80–7.

Chen YH, Shao WJ. Intelligent care for aged: connotation, dilemma and suggestions. Jianghuai Trib. 2021; (2): 139–45.

Faulkner SL, Trotter SP. Theoretical Saturation. The International Encyclopedia of Communication Research Methods. 2017: 1–2.

Du CL, Zang LH. From “fragmented operation” to “holistic governance”: research on the path innovation of smart pension service supply driven by big data. Study and Practice. 2020(7): 92–101.

Li CY. Problems and countermeasures of application of “Internet Plus” in the community home — based endowment services. J Beijing Univ Posts and Telecommuni (Social Sciences Edition). 2016;18(5):67–73.

Xu L, Li L. Internet Plus Smart Elderly Care: a community home-based elderly care service model based on the concept of O2O. Chin J Gerontol. 2021;41(12):2675–81.

Du CL, Zang LH. Administrative absorption or resource capture: research on the interactive relationship between government and social organizations in Smart Pension Service — based on the analysis of the smart elderly care service project on the Y street of SuNan. J Tianjin Adm Inst. 2021;23(2):77–85.

Jiang YJ, Zhang J. Content analysis of the development of interview script in nursing dissertations. Nurs J Chin PLA. 2016; 33(24): 32 – 5.

Li CX, Shi PY. Between the bureaucracy and the market: hybrid governance of governmental service outsourcing projects: an organizational study from information ambiguity perspective. J of Public Manag. 2019;16(1):29–40.

Zhan GB. The demand-side imperfections, supply-side imperfections and smart buyers: Dilemma for government services outsourcing and its solution. Comp Econ Soc Syst. 2013; (5): 142–50.

Chen TX, Zheng JS. Bringing the government back: a new trend in the purchase of services by the government. Theor Explor. 2019; (6): 13–9.

Yang W. Research on development opportunities and countermeasures of the elderly care industry in the New Era. Contemp Econ Manag. 2021;43(7):86–90.

Zhang Q. Why did smart elderly care service encounter the difficulty of popularization and promotion — analysis of the value networks based on the intelligent elderly care service industry in Qingdao. Theory J. 2020;5:130–9.

Gen YZ, Wei YN, Zhou J. An investigation into the issue of “Internet + elderly care” development. Macroecon Manag. 2019;1:71–7.

Chen N. From supplier led to consumer led: an analytical framework on the supply of home-based elderly care services in China. Enterp Econ. 2017;36(8):187–92.

Gen YZ, Wang XB. The Internet+” service for the elderly: opportunities, predicaments and solutions. J Shenzhen Univ (Humanities & Social Sciences Edition). 2017;34(4):109–14.

Tong X. Developing community home-based elderly care services to cope with aging. Explor Free Views. 2015;8:69–72.

Zheng Y, Liu W. Job satisfaction, subjective well-being and job performance. Res Financ Econ Iss. 2012;12:23–30.

Zhang B, Xiong SC, Jiang HB, et al. Mediating effect of job satisfaction between professional identity and turnover intention in nurses. Chin J Clin Psychol. 2016;24(6):1123–5.

Social Welfare Center of the Ministry of Civil Affairs. The employees of pension institutions are in the state of “two high and three low”. China Philanthropy Times. 2015: 3.