Journal of Aging & Social Policy最新文献

The Korean government implemented the pilot project for community care for older adults in June 2019. This study investigated the outcomes of the pilot project among Korean older adults by linking survey data from the pilot project with data of Korean National Health Insurance Service. The final sample included 17,801 pilot project participants and 68,145 in a matched comparison group. Pilot program participants experienced an increase of 4.8 days for length of home stay and a reduction of $956 (US) per participant relative to the matched comparison group. Pilot program participants with long-term care insurance who used home care services experienced an increase of 8.9 days for length of home stay and a reduction in $1,177 (US) in total costs, along with a reduction in the admission to long-term care facilities, compared to the matched comparison group. Patients discharged from hospitals indicated an increase of 35.2 days for length of home stay and a reduction of $6,947 (US) in total costs, but a 3.53 times increase in hospital readmissions relative to the matched comparison group. The pilot project for community care resulted in increased length of home stay and reduced total costs among older adults in Korea.

Technology is increasingly being integrated into Age-Friendly Environments (AFEs). This study explores how technology is manifested in AFE policies in China. We conducted a content analysis of 176 policies spanning seven years to identify the relationship between technology and AFEs and the characteristics of policy development. The findings indicate that technology plays a role in advancing a smart age-friendly society, particularly in terms of enhancing community support and health services and promoting social inclusion. The findings also reveal a list of policy actions and changes in collaborative leadership and strategic priorities throughout policy development. This study emphasizes the need for ongoing policy attention to technology as an integrated component of AFE policies.

Policies aimed at increasing employment among older people often focus on the statutory retirement age. Taking into account the characteristics of workers and work-related factors, we examine the impact of reaching the statutory retirement age on continuing employment. In addition to the use of survival trees, we propose a novel method to predict the probability of staying in employment based on an ensemble of survival trees. We focus on Poland as an example of a European country with a particularly low share of older workers in the labor force. Moreover, reform was carried out in Poland in 2017, lowering the previously raised pension eligibility age. Like other EU countries, pension eligibility in Poland starts after reaching the statutory retirement age. Our results suggest that the timing of retirement is determined by the statutory retirement age to a limited extent compared to other factors. In the case of women, a match of education and occupation, the employment sector, and holding a managerial position had a greater impact on continuing employment than reaching retirement age. In the case of men, the type of job contract had the greatest impact on continuing employment. Our findings indicate that the policies and initiatives aimed at extending working life should pay more attention to work-related factors and gender differences in employment.

Since the 1960s, the goal of active longevity has been mentioned repeatedly in Russian policy documents on aging and aging-related research. Analyzing current policy documents revealed divergences in the ways the term was interpreted, which in turn allowed for aging policy to develop in more than one direction. One policy development path considers active longevity to be more or less synonymous with the active aging concept. It focuses on older people's potential, and measures policy progress according to the Active Longevity Index (ALI). Another takes a more holistic approach, seeing active longevity as a policy goal in itself, alongside healthy aging, employment, social participation, and older people's contribution to society in ways that suit them. The latter approach accords with previous policy implementations in Russia and with extensive research data collected from various Russian regions since the 1940s. Preliminary observations on active longevity policy implementations show progress in health-care development and multiple opportunities for older people` social participation. However, data on older people's employment and life expectancy challenge the effectiveness of policy and cast doubt on the reliability of the ALI. A more flexible approach and the application of accumulated data and knowledge may assist in achieving active longevity policy goals.

The need for caregivers is a crucial issue in Thailand. This research examined levels and trends of household needs and unmet needs for caregivers of older persons and explored potential factors associated with these needs. The analysis utilized data from the Survey of Older Persons in Thailand 2007, 2011, 2014, and 2017. The household need for a caregiver of older persons was defined as a household with one or more older people who needed a caregiver to help them perform basic activities of daily living. The unmet need for a caregiver referred to households where at least one older person in the household needed care but did not receive it. Findings illustrated the increasing levels and trends of household needs as well as unmet needs over time. In terms of potential determinants, older person households in Bangkok and households with higher socioeconomic status were more likely to be the household need for caregivers. In contrast, those households in the Northeastern, the poorest region, were more likely to be the unmet need household. These findings are indicative of the rising demand for long-term care services in Thailand. However, it is vital to consider unmet household needs, especially in the worse-off area, when designing national policies.

International comparisons of long-term care (LTC) are hampered by inconsistencies in how to define the need for care. This is especially relevant for the European Union, whose Aging Working Group, which is tasked to project aging expenditure in the long term, has over time used two competing definitions - one based on inability to perform Activities of Daily Living (ADL) and another based on the more subjective Global Activity Limitation Index (GALI). The inconsistency in measurement, as well as problems in defining the intensity of needs, will acquire growing significance as longevity progresses. This paper investigates how the two measures are linked, by analyzing a large European sample survey where respondents replied to both questions. This allows a calibration of the two measures and an investigation of their areas of overlap and difference. The paper concludes by proposing a simple new 4-scale measure of care needs which, by combining the two metrics, introduces some gradation of the intensity of care. Using a consistent measure incorporating intensity, such as the one proposed, will facilitate international comparisons, improve long-term expenditure projections, and aid policy discussion, including the transfer of best practice.

Globally, the number and proportion of people aged 60 years and older is growing fast. As people age, health needs become more complex, and the health system's responsiveness to older people's needs requires evidence-informed policies. Hence, this study explores the factors affecting the health policy development process for older people in Iran. We conducted 32 interviewers with people aged 60 years and older and 21 interviews with key informants involved in policy making related to older people. Qualitative data were analyzed using thematic analysis. Actors and stakeholders, policy structure, selected health policy processes, the health care service delivery system, government financial support, and community and culture building are the most influential factors in health policy making for older people. Government policies and health priority interventions are needed to address these influential factors for older people to ensure healthy aging over the life course.

South Korea's National Long-term Care Insurance (NLTCI) has received international acclaim for its universal continuum-of-care model. Based on 25 qualitative interviews with family caregivers, this research explores the relationship between NLTCI policies and experiences of family caregiving for older people. Caregivers who share care responsibilities or are supported by other family are coping well with minor to moderate policy recommendations. Lone caregivers without support from other family are struggling and express desire for expanded services. These findings highlight a need for more consideration of the influence of family dynamics on informal caregiver burdens. Despite many strengths, NLTCI policy functions as a pressure release valve, supplementing family care for seniors - not replacing it - with minimal gender equity contributions.

Understanding individuals' long-term care preferences is essential to the provision of person-centered care. This study aims to describe the preferences for long-term care settings and investigates sociocultural factors associated with long-term care preferences among older Chinese adults. Responses from 22,112 older adults aged 60 years or above were analyzed using multinomial logistic regression. Four ideal long-term care settings were identified: in-home care, community day care, institutional care, and undecided long-term care arrangements. The study found that the majority of participants desired to age in place at home, regardless of their health status and social support conditions. Therefore, research and advocacy efforts are needed to inform policymakers to strategically develop home-based long-term care supports in China.

This study evaluates how various village services help older Indonesians perform daily activities and reduce age-related disability. Individual-level data from the 2020 National Socio-Economic Survey (SUSENAS) (N = 121,961 older people) and community-level data from the 2018 Village Potential Data Census Collection (PODES) (N = 83,931 villages in a data aggregation across 514 municipalities) were used in a multilevel binary logistic regression model. The interclass coefficient correlation (ICC) was calculated to determine the variation in characteristics across 514 municipalities to explain the differences in functional status. The ICC was approximately 16.2%, indicating that creating an age-friendly environment would help to delay the onset of disability. Older populations in Indonesia have a high percentage of informal employment, a low educational level, low percentages of affluent households, and few leisure activities. The findings highlight that the development of age-friendly services in the village should consider employment status and leisure activities. Participation in employment is a well-acknowledged concept for promoting active aging in developed nations but is secondary in managing age-related disability in Indonesia. The municipal government must develop an aging-friendly community (AFC) to create a supportive environment to meet the basic health and social needs of older people with age-related disability.