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Article
Publication date: 19 October 2012

Yanxia Zhang and Wei‐Jun. Jean Yeung

Asia's traditional experiences with care provision differ considerably from those of the West given the prevalent family‐based social norms about care and policies in this…

1312

Abstract

Purpose

Asia's traditional experiences with care provision differ considerably from those of the West given the prevalent family‐based social norms about care and policies in this region. In recent decades, Asia has experienced profound social and demographic transformations and is thus faced with significant challenges around care. However, care in Asian countries is a relatively less studied topic. There is an urgent need for a comparative study on recent policy and practice changes in care for the elderly and young children in different regions of Asia. The purpose of this special issue is to examine complicated boundary shift in care provision and financing between the state, market, community and family in East, Southeast and South Asia and to explore the implications of these changes in care policies and practices for social stratification by class and gender in Asia.

Design/methodology/approach

The introduction to this special issue gives an overview of the social and demographic transformations and new strains on care in Asia as a background and introduces the framework of welfare mix employed in this special issue, especially the concepts of social care and the welfare/care diamond.

Findings

The introduction summarizes the variations in regard to the governance and provision of care between different Asian countries and compares the differences in the state involvement between Asia and Europe.

Originality/value

The authors also discuss some of their contributions to methodological approaches and analytical frameworks in studying care and the implications of the current research for future studies.

Details

International Journal of Sociology and Social Policy, vol. 32 no. 11/12
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 13 June 2016

John Crossland

The planning and provision of care for older people in the lesbian, gay, bisexual and trans (LGBT) communities is an increasing challenge to traditional welfare systems…

Abstract

Purpose

The planning and provision of care for older people in the lesbian, gay, bisexual and trans (LGBT) communities is an increasing challenge to traditional welfare systems. The purpose of this paper is to explore the potential of the newly implemented Care Act 2014 in England for developing an anti-discriminatory approach.

Design/methodology/approach

The review draws on existing research and conceptual literature to identify how key provisions of the new act can be interpreted in light of current knowledge.

Findings

Overall the provisions of the Care Act lend themselves well to positive interpretation in relation to the needs of older LGBT people and their support networks. A potential tension, however, arises in the locality focus of the legislation that could constrain good practice with geographically dispersed communities. There is also a need to challenge both heteronormative and ageist assumptions that lead to older LGBT people remaining unrecognised.

Practical implications

Applied with imagination and commitment, the provisions of the new act could enable new forms of person-centred care to emerge to support older LGBT people.

Social implications

Social workers are in a key position to influence how the Care Act is interpreted and applied in practice and can act as change agents for a societal move towards older LGBT people having greater choice and control over their well-being.

Originality/value

This review presents examples of how the provisions of the legislation can be utilised to support positive change for older LGBT people.

Details

Quality in Ageing and Older Adults, vol. 17 no. 2
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 6 May 2014

Fiona Carmichael and Marco G. Ercolani

Older people are often perceived to be a drain on health care resources. This ignores their caring contribution to the health care sector. The purpose of this paper is to…

Abstract

Purpose

Older people are often perceived to be a drain on health care resources. This ignores their caring contribution to the health care sector. The purpose of this paper is to address this imbalance and highlight the role of older people as carers.

Design/methodology/approach

The study uses a unique data set supplied by a charity. It covers 1,985 caregivers, their characteristics, type and amount of care provided and the characteristics and needs of those cared-for. Binary and ordered logistic regression is used to examine determinates of the supply of care. Fairlie-Oaxaca-Blinder decompositions are used to disentangle the extent to which differences in the supply of care by age are due to observable endowment effects or coefficient effects. Nationally representative British Household Panel Survey data provide contextualization.

Findings

Older caregivers are more intensive carers, caring for longer hours, providing more co-residential and personal care. They are therefore more likely to be in greater need of assistance. The decompositions show that their more intensive caring contribution is partly explained by the largely exogenous characteristics and needs of the people they care for.

Research limitations/implications

The data are regional and constrained by the supplier's design.

Social implications

Older carers make a significant contribution to health care provision. Their allocation of time to caregiving is not a free choice, it is constrained by the needs of those cared-for.

Originality/value

If the burden of care and caring contribution are measured by hours supplied and provision of intimate personal care, then a case is made that older carers experience the greatest burden and contribute the most to the community.

Details

International Journal of Social Economics, vol. 41 no. 5
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 11 January 2016

Rocco Palumbo

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional…

4313

Abstract

Purpose

The purpose of this paper is to contextualize the concepts of “service co-production” and “value co-creation” to health care services, challenging the traditional bio-medical model which focusses on illness treatment and neglects the role played by patients in the provision of care.

Design/methodology/approach

For this purpose, the author conducted a systematic review, which paved the way for the identification of the concept of “health care co-production” and allowed to discuss its effects and implications. Starting from a database of 254 records, 65 papers have been included in systematic review and informed the development of this paper.

Findings

Co-production of health care services implies the establishment of co-creating partnerships between health care professionals and patients, which are aimed at mobilizing the dormant resources of the latter. However, several barriers prevent the full implementation of health care co-production, nurturing the application of the traditional bio-medical model.

Practical implications

Co-production of health care is difficult to realize, due to both health care professionals’ hostility and patients unwillingness to be involved in the provision of care. Nonetheless, the scientific literature is consistent in claiming that co-production of care paves the way for increased health outcomes, enhanced patient satisfaction, better service innovation, and cost savings. The establishment of multi-disciplinary health care teams, the improvement of patient-provider communication, and the enhancement of the use of ICTs for the purpose of value co-creation are crucial ingredients in the recipe for increased patient engagement.

Originality/value

To the knowledge of the author, this is the first paper aimed at systematizing the scientific literature in the field of health care co-production. The originality of this paper stems from its twofold relevance: on the one hand, it emphasizes the pros and the cons of health care co-production and, on the other hand, it provides with insightful directions to deal with the engagement of patients in value co-creation.

Details

International Journal of Public Sector Management, vol. 29 no. 1
Type: Research Article
ISSN: 0951-3558

Keywords

Book part
Publication date: 12 December 2007

Matthew E. Archibald

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse…

Abstract

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse treatment provision among individuals of varying socioeconomic and racial/ethnic backgrounds. This study investigates that achievement by analyzing the relationship between community socioeconomic and racial/ethnic disadvantage and organizational provision of substance abuse treatment, treatment need and utilization across United States counties, 2000, 2002 and 2003. Results confirm equity in service provision in poorer communities and those with higher concentrations of African Americans. Significant disparities remain, however, in communities with higher concentrations of Hispanics, youth and female-headed households. Limitations and implications for future studies of health care provision are discussed.

Details

Inequalities and Disparities in Health Care and Health: Concerns of Patients, Providers and Insurers
Type: Book
ISBN: 978-0-7623-1474-4

Article
Publication date: 1 December 2003

Alison Petch

Intermediate care has featured strongly in evolving strategy for support provision for older people in England. In Scotland the concept appears to have been rejected in…

Abstract

Intermediate care has featured strongly in evolving strategy for support provision for older people in England. In Scotland the concept appears to have been rejected in favour of an emphasis on integrated care. This apparent divergence is explored in the broader context of policy variation post‐devolution and against the aspirations for a whole‐system approach.

Details

Journal of Integrated Care, vol. 11 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 3 October 2021

Phoebe Stirling and Gemma Burgess

This paper asks how the introduction of “smart” digital technologies might affect the goals that can be attributed to telecare for older people, by those coordinating its…

Abstract

Purpose

This paper asks how the introduction of “smart” digital technologies might affect the goals that can be attributed to telecare for older people, by those coordinating its provision.

Design/methodology/approach

A total of 29 in-depth, qualitative interviews were conducted with local authorities, housing associations and other organisations coordinating smart telecare provision, as well as telecare manufacturers and suppliers. Interviews were analysed by using qualitative thematic analysis.

Findings

The analysis reveals discrepancies between the goals and outcomes of smart telecare provision, according to those coordinating service delivery. This study concludes that the goal for smart telecare to be preventative and cost-efficient may be complicated by various organisational and operational challenges associated with coordinating provision.

Originality/value

New, “smart” telecare technology for older people stands apart from earlier, user-activated or automatic devices. It may have distinct and under-researched organisational and ethical implications.

Details

Housing, Care and Support, vol. 24 no. 2
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 19 October 2012

Yanxia Zhang and Mavis Maclean

The economic reforms which turned the centrally planned economy to a market economy have profoundly changed the tripartite relationship between the state, work unit, and…

Abstract

Purpose

The economic reforms which turned the centrally planned economy to a market economy have profoundly changed the tripartite relationship between the state, work unit, and citizen in urban China and brought significant changes to the institutional care provision for young children. The aim of this paper is to investigate the changes to the institutional care since 1980, with particular emphasis on the most recent years from mid‐1990s, and explore how the institutional care has changed over the recent decades without a clear institutional basis.

Design/methodology/approach

The analysis draws on second‐hand materials from published literature, a range of longitudinal national and local statistics and policy documents, and also on first‐hand information which was collected in Beijing from in‐depth interviews with key informants and case studies of different kinds of kindergartens.

Findings

The paper finds that the previous work‐unit based public care system has changed to a much more complicated care mix in which the roles of the state, employer, community, market and the informal sector of the family in terms of provision and funding have all changed significantly.

Social implications

The findings of this paper may help to inform appropriate policy responses in Chinese child care provision. The study suggests that formal care provision should be expanded towards universal access regardless of people's income and employment status in China.

Originality/value

The paper questions and complicates the “state withdrawal” representation of social welfare change and argues that it is not “the state” but “the work unit and community organization” retreat from public care provision. It also argues that the change in the role of the state has been multifaceted, and not a simple one‐directional movement of marketization in which the state retreated from welfare provision in entirety.

Details

International Journal of Sociology and Social Policy, vol. 32 no. 11/12
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 25 February 2011

Daisy Bogg

The emphasis on outcomes rather than process is an area that is receiving significant attention across the delivery of public sector services, and the question ‘so what?…

Abstract

The emphasis on outcomes rather than process is an area that is receiving significant attention across the delivery of public sector services, and the question ‘so what?’ is increasingly being asked of service providers. With service user self‐direction being the focus of both provision and commissioning over the coming years, there will be an increasing need to justify the delivery and development of social care in terms of the end result. Strong leadership and vision is required across the public sector if this change, in both organisational culture and service user expectation, is to be achieved.Leadership as both a competency and an organisational function has been well researched within health and social care. The literature largely points towards the need for clarity and strength within the strategic vision, especially when considering the management of change and multifaceted partnerships, both of which are crucial to the delivery of social care outcomes. The actual detail of the outcome framework, and the means by which it can be measured and quantified, is still an area of debate, and as such the aim here is to highlight some of the benefits and barriers that may be faced as the reform of the social care system evolves, with a specific focus on the impact that leadership can have on the delivery of an outcome‐focused mental health social care serviceThe analysis of outcome‐focused organisations is a relatively new concept in health and social care, and as such this paper seeks to debate the evidence in terms of whether leadership contributes to better service user outcomes in mental health social care. Dynamics within organisations, professions and with service users are all key considerations in the achievement of positive outcomes, and the role of the leader is to empower the staff group to power share and move towards co‐production in order to embed choice, control and service user contribution in the overall philosophy and culture of mental health service provision and developments.The overall conclusions of this paper are that leadership is important in terms of shaping services, ensuring governance and promoting innovation, and as a result it is possible to suggest that leadership and positive outcomes do have a direct correlation.

Details

International Journal of Leadership in Public Services, vol. 7 no. 1
Type: Research Article
ISSN: 1747-9886

Keywords

Article
Publication date: 19 October 2012

Mary Daly

This article provides an overview and analysis of care as a concept and object of policy makers' attention in Europe, mindful especially of the lessons that can be drawn…

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Abstract

Purpose

This article provides an overview and analysis of care as a concept and object of policy makers' attention in Europe, mindful especially of the lessons that can be drawn from the European experience. The aim of this paper is to set out a framework to understand care and also to offer an account of the way that different European countries have provided for care (of children and older people) and how existing policies are being reformed and rethought.

Design/methodology/approach

The article underlines the complexity of care as a concept and domain of policy and suggests the need for a broad‐ranging approach to its analysis.

Findings

It shows that the policy configuration has to be thought of as being embedded in and in many ways a function of the primary location and forms of care, the values and culture surrounding care and the arrangements around the mix of providers and modes of governance. While there are many positive lessons from the extent to which European states have become involved in making provision for care – offering financial and other forms of support to families and those needing care and enabling women to pursue a life not completely defined by their care‐related obligations – there are also negative ones such as the outstanding need to connect up policies for care across the life spectrum (in the term used in this article: a care configuration) and to view care in a global way.

Originality/value

This article takes an overview of recent developments in Europe and draws out the implications of developments in Asia.

Details

International Journal of Sociology and Social Policy, vol. 32 no. 11/12
Type: Research Article
ISSN: 0144-333X

Keywords

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