The Impact of Private Sector Provision of Home-Based Services for Older People in Beijing

Transcription

1 Internatonal Journal of Research n Socology and Anthropology (IJRSA) Volume 3, Issue 4, 217, PP ISSN The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng Ru Kang 1,*, George Leeson 2, Laurel Hxon 2 1 School of Labour Economcs, Captal Unversty of Economcs and Busness, Bejng 17, Chna; 2 Oxford Insttute of Populaton Ageng, Unversty of Oxford, Oxford OX2 6PR, UK Abstract : The prvate sector n Chna plays an ncreasngly mportant role n the provson of home-based servces for older people as the number of older people and ther care and support needs ncrease. However, Publc-Prvate Partnershp (PPP) s relatvely new n Bejng. Ths paper explores the relatonshp between the use of and the satsfacton wth home-based servces for older people provded by the prvate sector on the one hand and the fnance, regulaton, prvate sector condtons, and an ndvdual s stuaton on the other hand. The analyses make use of both the statstcs data and survey data. The results of the analyses suggest that use of these servces s affected by the coverage of the prvate sector and professonal staff, the older person s penson and number of ther chldren. In addton, satsfacton wth servces s nfluenced by fnancal contrbuton from the local authorty as well as the level of regulatons on subsdes, the coverage of the prvate sector and professonal staff, and the older person s expendture. In concluson, n order to further mprove and develop PPP n the provson of home-based servces for older people n Bejng, we suggest that polcy should focus on the expanson of servce provders and professonals to ncrease the coverage. In addton, local authortes should be nvolved fnancally, especally n subsdes for older people based on means-testng. Keywords: Publc-Prvate Partnershp; home-based servces for older people; use and satsfacton 1. INTRODUCTION Gven the ageng populaton, a surge n the amount of older people puts forward unprecedented demand for dverse development of home-based servces supply. Accordng to the goal of the Chnese government, 9% of the older populaton wll be spendng ther old age at home n the future. The most effectve ways of achevng these goals are to ncrease the number of servce supplers and to develop the dversty of servce delveres. PPP has been adopted n the servces provson system for older people as the number of older people ncreased sharply around the world. As a result, scholars on the prvate sector provson of home-based servces for older peopleare conductng a wde range of research. Internatonal artcles have put forward the necessty of the cooperaton between the publc and prvate sectors. Savas, for example, shows that the government s responsble to choose servce provders, to arrange servce content and to supervse the servce qualty based on the New Publc Management Theory[1]. Evans and Shelds ndcate that the prvate sector s not only a complement to the publc but also equal partner. PPP helps to mprove the status of the prvate sector[2].kotler ponts out that the prvate sector brngs forth new deas and enables flexblty so that the dverse need of older people can be better consdered[3]. Wettenhall takes PPP as an example to ndcate that cooperaton between the publc and the prvate sectors can optmze the allocaton of resources and mprove the overall plannng ablty of the government[4].in contrast, 1.Savas, E.S. Prvatzaton and the new publc management. Fordham Urb 2, 28, Avalable onlne: 2.Evans,B. M., Shelds,J. Neolberal Restructurng and the Thrd Sector: Reshapng Governance, Cvl Socety and Local Relatons. Workng Paper, Centre for Voluntary Sector Studes, Ryerson Unversty, 2. 3.Kotler, P., Murray, M. Thrd sector management-the role of marketng. Publc Admnstraton Revew 1975, 35, Avalable onlne: 4.Wettenhall, R. The rhetorc and realty of publc-prvate partnershps. Publc Organzaton Revew23, 3, Avalable onlne: Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 21

2 Ru Kang et al. some scholars have expressed concerns about the partcpaton of the prvate sector. Accordng to the Tradtonal Welfare Economcs, publc servce provson s the natural duty of a government department. Moreover, the government s the only provder because the servce capablty of the prvate sector s rather lmted [5].Concernng the beneft of the government, Corbettponts out the query of the transacton cost n the process of PPP; he also clarfes that the government s at a dsadvantage because of ts more rgd economc system f the prvate sector s brought nto the market [6]. Chanalso declares thatthe revenue n PPP cannot meet ts expendture[7]. Concernng prvate sectors, they are faced wth market, management, operaton andncome rsks n cooperatng wth the publc sector. Experts also have ther own evaluaton ndex system showed to support ther debate on the use of servces for older people. Some scholars argue about the factors nfluencng socal care condtons of older people. Psycho-socal determnants (e.g. ncome, health-related behavors, socal excluson and poverty) affect a great amount wth respect to the need and consequent use of servces. Use of socal care servces s dependent on soco-economc status (SES) or socal captal. The older people who are lower n term of SES are less lkely to dscuss health ssues or have access to support groups [8]. Researchers n Chna concentrate on how to promote the collaboraton from a theoretcal perspectve rather than va practcal research. Most specalsts and scholars recommend the prvate sector enlarge the scale of the servces for older people. Mudemonstrates that t s essental to carry forward the government s fnancal contrbuton[9]. Su proposes establshng of a legal system to regulate the government's purchasng socal care servces [1].Guosuggests brngng qualty supervson and the ndex system nto the whole development plan of servces for older people and settng up a thrd-party evaluaton and audt system[11]. Accordng to the research lterature above, although the results vary among dfferent methods and dscplne background adopted, they overlook an mportant perspectve. It s the older people who receve the servce ultmately. Most of the prevous research n macroeconomcs has explored the mpact of PPP on both publc and prvate sectors rather than consder the perspectve of the older people. User channel s dffcult to be foundn the prevous artcles. The way to better understand the effect of the prvate sector provson of home-based servces for older people s the response from the ndvduals. Our research specally addresses these challenge. In order to allow the older people to enjoy home-based servces at home and acheve well-beng for the rest of ther lves, the research focuses on how to make full use of the prvate sector accordng to the demand of the older people. Consequently, we am to nvestgate the mpact of PPP on the use of and satsfacton wth home-based servces usng survey data n Hume, D. A Treatse of Human Nature; Courer Corporaton: Massachusetts, US. 212;pp Corbett, P., Smth, R. An Analyss of the Success of the Prvate Fnance Intatve as the Government s Preferred Procurement Route, Proceedngs of the Acceleratng Excellence n the Bult Envronment Conference, Brmngham, UK, Chan, D.W.M.,Chan, A. P. C.,Lam, P. T. I.A. Feasblty Study of the Implementaton of Publc Prvate Partnershp(PPP)n Hong Kong, Proceedng of the CIB W89 BEAR 26 Internatonal Conference on Constructon Sustanablty and Innovaton, Hongkong, Bell, A. V. I Thnk About Oprah Socal Class Dfferences n Sources of Health Informaton. Qualtatve Health Research214.24, Avalable onlne: 9.Guangzong, M. Chna's Insttutonal Penson Dffcultes and Countermeasures n the Development of Agng servces. Journal of Chna Central Normal Unversty212, 2 : (In Chnese) Avalable onlne: cnk.net/kcms/detal/detal.aspx?dbcode=cjfq&dbname=cjfd211&flename=hzsd21157&v=mtu3 NTRxVHJXTTFGckNVUkwyZllPZHJGQ2ptVWIzQUxUZllhckcSDlETXFvOUZZNFI4ZVgxTHV4WVM3 RGgxVDM= 1.Su, M., Ja, X., Sun J., Han, J.K. Chna's Government Purchase of Publc Servces Research. Journal of Fnancal Research21,1, 9 17.(In Chnese) Avalable onlne: dbcode=cjfq&dbname=cjfd21&flename=czyj2114&v=mduwmddtnromvqzcvryvxrn JDVVJMMmZZT2RyRkNqbVdyckpKamZTWkxHNEg5SE1ybzlGWUlSOGVYMUx1eFk= 11.Guo, L. Typcal Western Countres Prvate Captal Partcpaton n Penson Servce System Constructon Journal of Socal Scence Abroad 214,6, (In Chnese) Avalable onlne: l/detal.aspx?dbcode=cjfq&dbname=cjfdlast215&flename=gwsh21467&v=mdaymzndam5vc npbswpywvpyrzriovhncvk5rlkujhlwdfmdxhzuzdeadfum3fucldnmuzyq1vstdjmwu9kcky= Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 22

3 The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng Ths paper ncludes the followng parts: Secton 2 sets out the hstory and current condton of the cooperaton between publc and prvate sectors to supply home-based servces for older people n Bejng whch leads to some of the hypotheses; Secton 3 shows the hypotheses and research questons and dscusses the factors affectng the use of and the satsfacton wth the servces the older people acheve; Secton 4 offers data from Chna s survey and bulds data models to examne whether contrbuton of both the government and the prvate sector, and personal characters affect the share of home-based servces that the older people obtan and how they feel about these knds of servces; Secton 5 offers some concludng remarks. 2. PRIVATE SECTOR PROVISION OF HOME-BASED SERVICES FOR OLDER PEOPLE IN BEIJING PPP s classfed nto three forms under laws and gudance rules of Bejng: Voucher system, Government Grants or Subsdes, and Publc Bulds &Prvate Operates. The publc and prvate sectors partcpate wth dfferent roles n each of dfferent types; dvsons of responsblty between them are made n a varety of ways. The followng secton outlnes dscrmnatng characterstcs of each form and examnes how they cooperate to supply home-based servces for older people n Bejng A Voucher System The Bejng government publshed Home-based (Dsablty-assstve) Servces Methods, whch s called Nne Polces for Older Care n 29. There are nne categores of people who are elgble to receve the government-subsdzed voucher, ncludng older people (aged 8 and over), dsabled people, and those wthout chldren, whch are called Specal Old Person. They are pad a 1 yuan RMB (equal to $15.3 USD) voucher per month by the publc fnance. The voucher s used to pay for home-based servces, such as housekeepng and food delvery. Approxmately 45, older people were covered by ths polcy, whch accounts for 87.2% of all the older populaton over 8 at the begnnng of the establshment. The program has been extended to nclude 6-79 years olds n some dstrcts n Bejng as well snce 211. Furthermore, the value of the voucher has ncreased from 1 yuan to 2 yuan (equal to 3.6 USD). They can buy food, have a harcut and enjoy socal care servces usng the voucher wthn the prvate nsttutes specfed by the government. The voucher s stpend, compared wth the daly output of each older person, 1,366 yuan RMB (equal to USD) per month on average, helps ths demographc n a rather lmted way, as showed n Table 1. [122] Table 1. Household economes and subsdy for the older people n Bejng. Index Average Older people Per capta consumpton expendture(yuan/monthly) 3,88 1,367 Per capta dsposable ncome(yuan/monthly) 4,853 Government-subsdzed voucher (yuan/monthly) 2 Penson(yuan/monthly) 3, Government Grants or Subsdes Government Grants or Subsdes are derved from the Welfare Lottery Tcket Publc Fund and the Socal Securty Fund n Bejng. The Cvl Affars Bureau n each dstrct makes plans and apportons the fnance to apportons the fnances to the local authorty. In Bejng, older people go to the care center where there are nursng beds and luncheon clubs for older people; these facltes are located n the center of resdental area. The workers help the older people to ensure that ther lves are made easer n the professonal socal organzatons. It s the local authorty s task to supply a pager or telephone n older people s homes wth a grant from the central government. As of 214, there were 18,6 nursng beds n the neghborhood and 3429 luncheon clubs for older people n Bejng[13]. Rehabltaton servces are appled to the beds only used n the daytme. Older people can enjoy three 12.Report of Bejng Older Populaton Informaton and Development Status n 214. Avalable onlne at 13.Report of Bejng Older Populaton Informaton and Development Status n 214. Avalable onlne at Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 23

4 Ru Kang et al. meals a day there or have take-outs delvered to ther homes. Prvate caterng companes are n charge of makng all the meals and delvery Publc Bulds and Prvate Operators The government establshed ths knd of servce and asked prvate organzatons to bd for the runnng of t. The unt that wns the tender has the responsblty to tran the caregvers and provde sklled care servce for older people who call the hot lne. A total of 44 caregvers have been traned snce 214. The government also developed nsurance for older people who are taken care of at home wth the commercal nsurance companes. Both of them provde money and desgn for the nsurance products. Each nsurance costs for 17 yuan RMB (equal to $2.59 USD) annually The commercal nsurance companes provde a dscount for the older people who pay by themselves. The nsured older people can acheve at most.2 mllon yuan (equal to $3,376 USD) compensaton one year f they suffer death, dsablty, or burns when takng the muncpal transportaton or n the publc area. In concluson, the government programs and formatons of PPP are ntegral but are stll n ther begnnng stages. The Voucher System s the most popular among the older people because t s totally pad by the government and free for the ndvdual, they are more able to choose the servces on ther own. However, t s dffcult for the government to montor the process of voucher ssue and the dversty of servce provders. In the model of government grants or subsdes, a large amount of facltes are bult by the government, whch are crucal to the long-term development. Due to lack of professonal staff, the servces older people get, however, are lmted and they do not feel extremely satsfed wth the servces that prvate organzatons offer, both n terms of the qualty and quantty. Publc bulds and Prvate operators s a new emergng pattern and prvate sector s partcpatng awareness s weak. In addton, the dvson of responsblty between the publc and prvate sectors s ambguous mkng t less effcent than the other two models. 3. HYPOTHESES AND DATA 3.1. Therotcal Framework Accordng to Samuelson s Theory of Government falure, although the government plays an mportant role n provdng the publc product, whch s not avalable n the market prce mechansm, government falure cannot be handled successfully. Government falure s absence of effcent, resultng from the fact that the government s not able to acheve all the nformaton whether people need the publc product or not. Under such crcumstances, the prvate sector s partcpaton becomes partcularly mportant. [14]Socal welfare can be seen as publc product n the Publc Economcs and t should be provded by the whole socety, ncludng government, socal organzatons and ndvdual. The development consumpton of socal welfare s as follows: SW 1 * Publc 2* Pr vate (1) SW stands for the achevement of socal welfare; Publc and Prvate represent the contrbuton of government and prvate sector. SW 1 * Publc 2* Pr vate 3* Indvdual (2) In addton, Wemer and Vnng note that producton and dstrbuton of goods depends on both publc choce and personal choce. [15] Based on the Equaton (1), ndvduals can be the partcpant subject; Indvdual represents ndvduals or ther famles contrbuton Data Models Accordng to the theores mentoned above, we assume that older people s access to home-based servces depends on the resources they have, whch s supported by the government, the prvate sector and themselves even ther famly. Use of home-based servces for older people s affected on the one hand by the fnance, regulatons, prvate sector condtons, and an ndvdual s stuaton on the other hand. Older people s satsfacton wth the home-based servces s affected by the same factors. He and 14.Samuelson, P. A. Economcs.McGraw-Hll, Wemer D L, Vnng A R.Polcy analyss :concepts and practce.journal of Polcy Analyss & Management Avalable onlne: Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 24

5 The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng Wu nvestgated the use of ordnary least squares (OLS) n ther research of determnng the relatonshps between health care resource utlzaton and drect medcal costs for patents and found the OLS s superor to other optons [16]. Harde also appled the OLS regresson analyses to examne the relatonshp between behavoral health servces use and outpatent ntensty measures and acheve the robust outcome [17].To estmate the mpact of the prvate sector provson of home-based servces for older people, we use multple regresson estmated wth OLS. Based on the theoretcal framework dscussed above, we construct the basc data models wth the ndvdual-effect as follows: Use Fnance Re gulaton PSector PStaff Penson Expendtur e Income Demographcs ( 12,...,N ) LetUsebe the older people use of the home-based servces. It s the rato of people who have used the servce to all the respondents. Fnance means the amount of money the local authortes pay for older people and the prvate sector; Re gulaton shows whether there are regulatons or laws to prompt PPP n home-based servces for older people; PSector ndcates the quantty of prvate organzatons whch can provde home-based socal care servces n the local area and also contract wth the local authorty; PStaff ndcates the number of professonal staffs, ncludng nurse practtoners and caregvers who belong to the prvate sector. In terms of the ndvdual economcs resource, let Penson mean the old ndvdual s penson every month, Expendtur e be older people s lvng expense. Income ndcates the whole famly s ndcators. Demograph cs ncludes older people s age, gender, self-care ablty, health status, martal status, the number of chldren, and so forth. N s the sample sze. Satsfact on Fnance Re gulaton PSector PStaff Penson Expendtur e Income Demographcs ( 12,...,N ) Let Satsfact on be the evaluaton of older people on the home-basedservce they use. Other varables are the same n the Equaton (3), as demonstrated by Equaton (4) Data and varables The statstcs data n 215 can be collected from the statstcs offered by the Chnese Natonal Bureau of Statstcs, Bejng Bureau of Statstcs, and Cvl Affars Bureau. The statstc data nclude the local authorty fnance nto the PPP, the amount and scale of the domestc prvate companes, the amount of nurses and caregvers n every dstrct of Bejng. The Ynan Older Care Promoton Center conducted survey n the summer of 215, coverng698 respondents lvng n Bejng and aged over 6 years. The survey was wth respect to respondents personal characterstcs and the home-based servces they enjoyed. Respondents personal characterstcs ncluded age, gender, self-care ablty, health condton, martal status, the number of chldren, ndvdual penson and expendture, and famly s ncome. Self-care ablty was measured by some actvtes showed on the questonnare. The ntervewee could choose what actvtes they could do, such as havng a meal by themselves. Each actvty generated a dfferent score and our data takes the sum of all these scores. Health condton s self-evaluated by the old person who s gven fve levels to choose, rangng from very good, good, general, poor and very poor (3) (4) 16.He X, Wu J, Jang Y, et al. Health care resource utlzaton and drect medcal costs for patents wth schzophrena ntatng treatment wth atypcal versus typcal antpsychotcs n Tanjn, Chna. Bmc Health Servces Research215.15:149. Avalable onlne: nts+wth+schzophrena+ntatng+treatment+wth+atypcal+versus+typcal+antpsychotcs+n+tanjn%2c+ch na&rsv_bp=&tn=se_baduxueshu_c1gjeupa&rsv_spt=3&e=utf- 8&f=8&rsv_sug2=&sc_f_para=sc_tasktype%3D%7BfrstSmpleSearch%7D 17.. Harde, N. A., Lo Sasso, A. T., Shah, M., & Levn, R. A.. Behavoral healthcare servces use n health savngs accounts versus tradtonal health plans. J Ment Health Polcy Econ21. 13: Avalable onlne: sus+tradtonal+health+plans.&rsv_bp=&tn=se_baduxueshu_c1gjeupa&rsv_spt=3&e=utf- 8&f=8&rsv_sug2=&sc_f_para=sc_tasktype%3D%7BfrstSmpleSearch%7D Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 25

6 Ru Kang et al. There are 2 knds of servces provded by the prvate sector n total. We dvde them nto practcal help and personal care. The practcal help ncludes day center, hourly worker, shoppng, washng clothes, ppelne dredge, applance reparng, ndoor cleanng, water and electrcty nstallaton mantenance servce, sghtseeng, unversty for older people and tranng for older people. Personal care ncludes assstance wth drug admnstraton, harcut, bath assstance, psychologcal counselng, chattng and recreaton, famly health servce, sklled care servce, perodc health examnaton and accompaned doctor vsts. All the respondents are asked Overall, how satsfed are you wth the home-based servces you receve? Satsfacton s categorzed ntofve levels:( 1) extremely satsfed; ( 2) satsfed ; ( 3) medum ; ( 4) dssatsfed; ( 5) extremely dssatsfed. The varables were assgned 1-5 ponts. The use of and the satsfacton wth the home-based servces for older people are calculated n the followng table. Table 2. Means of dependent varables by category of demographc (N=698) Age Gender Self-care ablty Health Status Martal Status 8-89 Partcpants (%) Tota l Use of practcal help FemalMal e e Tota l Partall Complete Self-care dsable ly dsabled d Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 26 Tota l Ver y goo d Goo d Gener al Ver Poor y poor Marre Marre d but d and Tota not lvng l lvng togeth togeth er er Sngl e Tota l Use of personal care (N=313) Partcpants (%) Satsfacton A For the use of both two knds of servces, there are nverse U shapes when t comes to the age. Older people between 8 and 89 years of age use more servces than any other age bands. It can be seen from the chart above that older women tend to use practcal help less frequently than older men. Women n the study reported hgher use of the personal care servces than men. Older people are more avalable to the home-based servces wth the decrease n level of health. In terms of the self-care ablty, the partally dsabled and the completely dsabled people use the practcal help and the personal care most frequently. There s a remarkably low level of utlzaton of personal care servces wth only 22% of them are used by the older people wth extremely good health status. In accordance wth common assumptons, people who are marred and also lvng together use such servces the least and those who are sngle use them the most. Satsfacton wth the home-based servces fluctuates steadly as the age ncreases. It s apparent from the fgures that the older women feel more content than older men. Although a consderable ncrease occurs among the 7-79 years old, t reduces soon after 8 years of age. Satsfacton has a smlar trend wth the self-care ablty and health status. Completely healthy older people rate the servces they acheve at a hgher level than other groups. In other words, t comes down when the physcal condton goes worse. However, there s not a great deal of dfference among dfferent marrage statuses. 1

7 The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng Accordng to the data models, varables of nterest are summarzed and defned n Table 3. Table 3. Defnton of the varables. Use Satsfacton Publc sector Prvate sector Indvdual Famly Varables Symbol Defnton Use of practcal help It s the proporton of the servces older Use of practcal people have used out of all11 knds of help practcal help servces. Use of personal care It s the proporton of the servces older Use of personal people have used out of all9 knds of care personal care servces. Great dssatsfacton:1 Dssatsfacton:2 Older people s satsfacton wth Home-based Satsfacton General:3 Satsfacton:4 Great servces Satsfacton:5 Local authorty fnancng of PPP n homebased servces for older person and the Fnance prvate sector(yuan/yearly) Regulatons for PPP n home-based servce Regulaton for older people Coverage of the prvate sector Coverage of professonal staffs Older people s penson(yuan/monthly) Prvate sector Staff Penson Older people s expendture ndvdually Expendture (yuan/monthly) Household ncome (yuan/monthly) Age Household ncome Age Local authorty fnancng ncludes the vouchers, grants and other payments to the ndvdual and the prvate sector; t s dvded by the amount of older people n the local area. Regulatons refer to regulatons or laws to promote the PPP n home-based servce for older people, for example, tax preference polcy for the prvate sector. Inexstence: Exstence: 1 The prvate sector ncludes the company or organzaton, whch cooperates wth the publc and can provde home-based servces n the local dstrct. Coverage means the amount dvded by the older populaton. Professonal staffs nclude nurse practtoners and caregverswho belong to the prvate sector n the local dstrct. Coverage means the amount dvded by the older populaton. The penson older people acheve every month. It ranges among dfferent occupatons. Expendture covers clothes, food, health care, socal care servce, communcaton, transp ortaton, entertanment and other daly output. Household ncome covers household wage ncome and ndvdual-based transfers, selfemployed actvtes and household publc transfer ncome.the famly s ncome s dvded by the number of household members. Recpents actual age flled n the n questonnare. Gender Gender Female: Male:1 Self-care ablty Health Self-care:1 Partally dsabled:2 Completely dsabled:3 Demographcs Very good:1 Good:2 General:3 Poor:4 Health status Health Very poor:5 Martal status Martal Marred and lvng together:1 Marred but not lvng together:2 Sngle:3 The number of chldren Chldren The number of adult chldren who accompany the older people. 4. RESULT OF ANALYSIS 4.1. Descrptve Statstcs Accordng to the statstcs data found on the webste and the survey questonnare, descrptve statstcs of the varables are summarzed n Table 4. After the correlaton analyss, we cut the varables self-care ablty and martal status because of multple multplcty. Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 27

8 Ru Kang et al. Table 4. Descrptve statstcs of varables. Numbers of observatons Mean Standard Devaton Mnmum Maxmum Dependent varables Use of practcal help Use of personal care Satsfacton Independent varables Fnance Regulaton (65%) 1(35%) Prvate sector Staff Penson ,. Expendture , Household ncome ,. Age Gender (54%) 1(46%) Health Chldren As s seen n Table 3, 698 older people are ntervewed n whch 313 of them have used oneor more knds of home-based servces provded by the prvate sector. The maxmum use s 7% and the mnmum s 4%. For the satsfacton wth the servces, the mean s 3.25 and dfference s not obvous enough among the whole subjects. We wll take the base-1 logarthm of fnance, penson, expendture and household ncome n order to avod based estmaton from the extremely large amount The Impact on the use of Home-based servces for older people Based on the framework equaton (3) above, we construct the followng models to fnd the connecton between the use of home-based servces for older people and other factors. Table 4 shows the outcome of multple regressons. Accordng to the F test n the model, P s.1 and standard F statstc s sgnfcant at the 1% level, whch means the lnear relatonshp n the model s outstandng and the effect does exst. When t comes to the test result of the goodness of ft n the equaton, the adjusted R2 values are.9788 and.9167, whch shows that the model's ft s hgh. The Durbn- Watson (DW) values are and 2.219, whch verfy the absence of autocorrelaton among the ndependent varables. Table 4. Estmaton of the mpact on the use of home-based servces for older people. Varables Use of practcal help Use of personal care Fnance -.437(.41) -.782(.45) Regulaton 1.35**(.59) 1.6**(.47) Prvate sector.3(.2).9(.7) Staff -.126(.54) -.76**(.42) Penson -.1**(.43) -.4**(.3) Expendture -.12(.5) -.3(.31) Household ncome 2.83(.6) 2.438(.28) Age.238*(.2).814(.3) Gender 1.234(.49) 1.763(.1) Health -.1(.21) -.2(.68) Chldren -2.13**(.22) -3.24***(.44) _cons -2.12(.3) -3.89(.52) Adjusted R F P.1.1 From the analyzed outcome n Table 5, we can conclude that there are fve knds of factors that affect the use of both the practcal help and personal care servces provded by the prvate sector. Coverage of prvate sectors and older people s penson affect the use postvely. The use of home-based servces Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 28

9 The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng s hgher n the dstrcts where the extra regulaton on subsdy for older person and the prvate sector s avalable. On the contrary, wth the ncrease n the number of ther chldren, the use comes down. Moreover, people are more lkely to use the practcal help servce as the age ncreases. Other factors have no evdent correlaton wth the use. We also fnd a negatve correlaton between the coverage of professonal staffs and the use of the personal care servces The Impact on the Satsfacton wth Home-Based Servces for Older People Apart from the use, another mportant ndcator to examne PPP s older people s evaluaton. Lkewse, based on the framework equaton (3) above, we construct the followng model to fnd the connecton between user satsfacton wth home-based servces and other factors. Table 6 shows the outcome of multple regressons. Accordng to the F test n the model, P s and standard F statstc s sgnfcant at the 1% level, whch means the lnear relatonshp n the model s outstandng and the effect does exst. When t comes to the test results of the goodness of ft n the equaton, the adjusted R2 value s.7315, whch shows that the model's ft s hgh. The (DW) value s that verfes the absence of autocorrelaton among the ndependent varables. Table 6. Estmaton of the mpact on the satsfacton wth home-based servces for older people. Varables Coef. SE T P 95%CI Fnance Regulaton Prvate sector Staff Penson Expendture Household ncome Age Gender Health _cons Adjusted R F P. As demonstrated n Table 6, the coeffcents of fnance, regulaton, prvate sector, penson and expendture are postve, whch mples that the satsfacton of older people ncreases when the fnance of the local authorty, regulaton of subsdes, coverage of the prvate sector and older people s ndvdual expendture are addtve. The areas where there are extra subsdy regulatons for older people or the prvate sector are more lkely to rase the satsfacton. 5. CONCLUSION 5.1. Man Fndngs Ths artcle has focused on home-based servces for older people provded by the prvate sector va the user channel. Usng the latest data, we are able to measure the result of PPP. Older people s use of and satsfacton wth home-based servces are nfluenced by both of effectveness of PPP and personal characterstcs. In concluson, the use of home-based servces depends on the government s contrbuton as well as the older person s fnancal resources and famly structure. On the other hand, the satsfacton older people wth respect to the servces they have used s nfluenced by support from local authorty and prvate sectors. It also has a lot to do wth older person s expendtures and penson Dscusson of Fndngs Ths study presents the development of PPP from the perspectve of home-based servce recpents and ams to determne mproved methods of servce provson n Bejng. On the bass of Samuelson s Theory of Government Falure, we hypothesze that the use of, and satsfacton wth the servces provded by the prvate sector are nfluenced by government fundng and regulaton, the coverage of Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 29

10 Ru Kang et al. the prvate sector and ts professonal staff, economc resources and other demographcs of the ndvduals, and famly backgrounds. Second, the results ndcate that the use of and satsfacton wth home-based servces for older people provded by the prvate sector are postvely correlated wth the economc stablty of the servce users. Although addtonal subsdy s provded n some plot areas of Bejng, only a modest proporton of the ndvdual cost s covered. Physologcal needs become more mportant when the resources of an ndvdual are lmted. Indeed, most respondents state that the penson they receve only covers daly necesstes and medcal expendtures, at best. Influenced by tradtonal customs, older people n Chna prefer to save rather than consume. [18] Affluent older people prefer to save the balance to support ther chldren at the expense of ther well-beng; wth lmted money, they cannot afford hgh-qualty servces. In addton, the use vares across dfferent levels accordng to the number of chldren of older people. Specfcally, vouchers and subsdes provde a one-sze-fts-all soluton wthout stratfcaton: they cannot be adjusted accordng to varous types of famly structure. The knd of help needed by older people from the prvate sector and ts afflates vary accordng to ther number of chldren. For homebased servces, the functons of the famly and the prvate sector are complementary. For some bereaved parents or older people who lve far away from ther chldren, more resources should be provded to pay for the home-based servces; ths s the group wth urgent need. User satsfacton wth servces ncreases when the devoton of the publc sector s added. As PPP s now n the early stage, the coverage of the prvate sector specalzng n home-based servces for older people remans lmted. Thus, some unhealthy phenomena exst: the emergence of seller's market rases the prce of care servce, thereby restrctng consumer choce. In addton, older people have to wat n lne for an extended tme only to receve n adequate servce and ther needs are not addressed mmedately. Some prvate companes experence sgnfcant dffculty n recrutng personnel, partcularly staff specalzed n home care. Therefore, the level of satsfacton declnes because of poor servce qualty. What mplcatons we could obtan from the analyss are as follows: The exstng prvate sectors should expand the scale to mprove ther servces. Wth the support of local authortes, they should be encouraged to tran professonal caregvers who should be provded wth proper facltes to meet the dverse needs of older people. Ths s because our analyses suggest that coverage of prvate sector and professonal staffs have a postve effect on the servce use and estmaton. We also recommend ncreasng fnancal support to ndvduals and buldng a herarchcal voucher system of home-based servces for older people. Our fndng s applcable to certfy that the famly support and servce provded by the prvate are complementary. The mplcaton for future polcy-makng s that a survey has to be conducted to ascertan the care avalable for older people by themselves or from ther famles before any extenson. As dscussed earler, the number of chldren could be used as a potental assessment ndcator Lmtatons Ths study has several lmtatons. Frst, we examned, prmarly, the varables closely related wth the use of and satsfacton wth the home-based servces provded by the prvate sector for older people. However, the degree of mprovement remans uncertan. Consequently, we cannot precsely calculate the deal publc or prvate nvestments requred to fully satsfy the demands of older people. In addton, the level of satsfacton s evaluated by older people, although the recpents may choose from fve levels gven. The standards may vary among dfferent ndvduals. Expandng the sample sze s suggested to ensure the objectvty and effectveness of the model. 18. Modglan F, Cao S L.The Chnese Savng Puzzle and the Lfe-Cycle Hypothess. Journal of Economc Lterature24.42: Avalable onlne : /scence/artcle/p/ S143951X 1994 Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 3

11 The Impact of Prvate Sector Provson of Home-Based Servces for Older People n Bejng ACKNOWLEDGMENTS: Ths research s supported by the Chna Scholarshp Councl. The frst author would lke to apprecate the studyng experence provded by the Oxford Insttute of Populaton Ageng and would lke to thank George Leeson from the nsttute for hs helpful suggestons for the research. Specal thanks are also due to Cheng Zhang from the Unversty of Oxford and Hua Jang from Captal Unversty of Economcs and Busness for ther knd gudance on data mnng and proofreadng. Lastly we acknowledge the support from the SUHC team from Captal Unversty of Economcs and Busness for all the data provded and nteractons onlne. Ctaton: Ru Kang George Leeson & Laurel Hxon" The Impact of Prvate Sector Provson of Home- Based Servces for Older People n Bejng" Internatonal Journal of Research n Socology and Anthropology (IJRSA), vol 3, no. 4, 217, pp do: Copyrght: 217 Authors. Ths s an open-access artcle dstrbuted under the terms of the Creatve Commons Attrbuton Lcense, whch permts unrestrcted use, dstrbuton, and reproducton n any medum, provded the orgnal author and source are credted. Internatonal Journal of Research n Socology and Anthropology (IJRSA) Page 31