The empty bed rate reaches 50%! Institutional elderly care encounters a bottleneck. How can the elderly receive professional care at home?

The empty bed rate reaches 50%! Institutional elderly care encounters a bottleneck. How can the elderly receive professional care at home?

China Times (www.chinatimes.net.cn) reporter Yu Na reports from Beijing

On the one hand, the needs of elderly care cannot be met, and on the other hand, the high bed rate of elderly care institutions. How to get the elderly to receive professional care has become a common problem facing the three elderly care models at home, community, and institution.

“The three types of elderly care at home, community, and institutions have not been effectively integrated in China. The main manifestation is that institutional elderly care has encountered a bottleneck, and the vacancy rate is even close to half.” April 20, at the Boao Forum for Asia 2021 annual meeting Last, Luan Xin, deputy mayor of Qingdao, said when discussing the issue of welcoming an aging society.

At present, the global aging trend is irreversible. According to the United Nations’ definition of an aging society, major countries in the world such as China, the United States, Russia, and Japan have entered an aging society, especially Asian countries are accelerating their entry into an aging society.

How to mobilize the enthusiasm of individuals, enterprises and society to establish a sustainable, recyclable, fair and transparent health and old-age security ecosystem in which stakeholders actively participate, and finally realize that the elderly can enjoy a quality life in their old age without increasing young people Burdens and worries?

In this regard, Luan Xin puts forward three suggestions: First, we must coordinate three different elderly care models, that is, home, community, and institutional elderly care should be integrated and coordinated; in addition, the basic elderly care system should be improved and the supply of inclusive elderly care services should be improved. The government must do a good job in all-round services; at the same time, it must pay attention to market-oriented factors and vigorously promote the development of the elderly care industry.

The rate of vacant beds in institutions remains high

For many years, the domestic pension pattern has been “9073” or “9064”, that is, it has advocated that 90% of the elderly care for the elderly at home, 6% or 7% of the elderly care for the elderly in community institutions, and 3% or 4% of the elderly care for the elderly in institutions such as nursing homes. But in fact, the importance of institutional pensions has been highlighted by the industry in the past.

Affected by traditional culture, most elderly people prefer to provide for the elderly in their own homes, relying on the family as the basis and relying on the community to provide for the elderly. In November 2019, the Fourth Plenary Session of the 19th Central Committee of the Communist Party of China proposed to actively respond to the aging of the population and accelerate the construction of an elderly care service system that is coordinated with home community institutions and combines medical care and health care. The new idea of ​​coordinated development of elderly care in home and community institutions no longer emphasizes a certain form, and is more conducive to the construction of an elderly care service system.

During the “Thirteenth Five-Year Plan” period, home-based and community-based care has been launched in various areas. It is long-awaited that the elderly at home have certain demands for institutional care and community care. However, at present, home-based and community care is facing the elderly’s ability to pay, the implementation of support policies, and the implementation of support policies. Outstanding issues such as service model innovation.

In March 2021, the “Fourteenth Five-Year Plan for the National Economic and Social Development of the People’s Republic of China and the Outline of Long-Term Goals for 2035″ was formally proposed to promote the coordinated development of the elderly care industry and the elderly care industry, improve the basic elderly care service system, and vigorously develop inclusive benefits The type of old-age service supports the family to undertake the old-age care function, and builds an old-age service system that is coordinated with home and community institutions and combines medical care and health care.

It can be seen that the state’s top-level design for the coordinated development of home and community institutions for the elderly has been very clear, but there is a big gap in the actual situation.

Luan Xin said that the current three domestic pension models have not been effectively integrated, but are separated. The main manifestation is that institutional pensions have encountered a bottleneck, and the vacancy rate is generally very high across the country, reaching about 50%.

As of July 2020, data from the Ministry of Civil Affairs show that there are 42,300 old-age care institutions of various types across the country, with 4.291 million beds and 2.146 million elderly people. It can be estimated that the average occupancy rate of elderly care institutions is about 50%.

A survey by Qiao Xiaochun, a demographer and professor at the Population Institute of Peking University, also proved that in Beijing, a first-tier city with a serious aging population, “nearly 20% of the nursing homes have an occupancy rate of less than 20%, and 50% of the nursing homes live in. The rate is less than 50%. There are only 49 elderly care institutions that are really hard to find and have a 100% occupancy rate, accounting for only 10%.”

The low occupancy rate means that elderly care institutions are facing severe survival problems. However, the elderly care institutions under the 2020 epidemic have suffered an unprecedented impact, further increasing the vacancy rate of elderly care service institutions, but operating costs have increased significantly, posing great challenges to the daily operation of elderly care institutions.

“Due to the epidemic situation last year, the profitability of various elderly care institutions has dropped significantly and expenses have increased. In addition, closed management has made it particularly difficult to recruit service personnel, but the market demand for elderly care services is actually still very large.” Luan Xin believes that it must be adequate. Giving full play to the government’s policy and financial leverage, mobilizing the enthusiasm of all sectors of society, cultivating the elderly care service market well, and being able to grow bigger and stronger is also a very important part of the dual cycle.

Policy guidance supports integrated development

There is a nursing home called Humanitas home in the Netherlands. Young college students can live for free, as long as they accompany their “old neighbors” for 30 hours a month. The accompanying content includes chatting with the elderly, watching TV, and teaching the elderly video calls.

Some domestic elderly care institutions, which are deeply troubled by the vacancy rate, even asked whether they can follow the example of the Dutch elderly care institution, but the industry generally believes that such a solution is not suitable for national conditions.

To treat the symptoms as the root cause, Luan Xin believes that it is necessary to speed up the construction of an elderly care service system that coordinates homes, communities, and institutions, so that the advantages of the three models can be integrated and developed. The advantage of home care is that the elderly live in a familiar environment, and it is also very in line with the traditional Chinese thinking; the advantage of institutional care lies in the professionalization and standardization of services; community care is a platform, a connection, and one side Connecting the elderly who have full trust in it, while connecting with various elderly care institutions.

Luan Xin said that the lack of professional participation in home care is actually equivalent to living care; community care due to insufficiency, low service quality, irregular operation mechanism, and there is no way to meet the needs of the elderly in difficulties. Therefore, the above-mentioned series of problems can be solved well only when the advantages of the three models are brought into full play and integrated and developed.

For example, institutions for the elderly can be introduced into the community and provide door-to-door elderly care services, or the community can be used as a platform to integrate the elderly care institutions around the community to provide services for the elderly in the community. Fully mobilize institutions around the community to participate in elderly care services.

In 2020, the Fifth Plenary Session of the 19th Central Committee clearly put forward the “National Strategy to Actively Address the Ageing of the Population”, marking that my country’s elderly care services have entered a new stage. It is predicted that during the “14th Five-Year Plan” period, my country’s population over 60 years old will exceed 300 million, accounting for more than 20%. The number of aging population is very large, and a huge consumer market for elderly care services will be formed, and all parties need to be mobilized. The enthusiasm of participating in it, and actively expanding the elderly care services.

Luan Xin believes that the integration of community institutions and home-based care needs the government’s financial guidance and policy support to expand market involvement and play the role of the market.

Taking Qingdao as an example, there are community elderly care service centers in the urban areas, including rural streets, and community service points have also been established in each community, realizing the full coverage of home and community elderly care in the urban area, combining home care and community care in one. In order to ensure the quality of services and equip with a full set of supervision and supervision systems, the government must do a good job in supervision and supervision, and at the same time introduce third-party institutions with senior care experience through bidding to achieve standardization.

In order to solve the problem of payment for elderly care services for low-income groups, Qingdao has established a rural elderly filial piety fund to purchase socialized elderly care services for the elderly in rural areas, and raise the payment standards for long-term care insurance for the elderly in rural areas, and accommodate rural disabled and demented persons. The operating subsidy standard for the elderly, long-term care insurance not only covers the medical insurance of nursing care insurance, but also covers life care insurance.

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