Quality & Quantity

, Volume 46, Issue 2, pp 471–481

A causal model for the development of long-term facilities: a case in Taiwan

Article

Abstract

Elder care is an important issue in many developed countries such as U.S., Japan, and Taiwan. With the advent of population aging throughout the world, the development of long-term care facilities has become a very vital topic. In actuality, long-term care systems involve government oversight agencies as well as interaction between factors such as laws, social environment, culture, long-term care facilities, residents, and the families of residents, forming a complex and dynamic system. This paper uses system dynamics methodology to model the developmental structure of Taiwanese long-term care facilities to explore its system behaviors. The developmental structure of long-term care facilities in Taiwan is primarily composed of the four levels: overall satisfaction, overall service quality, the skill of administrative and medical care personnel and facility hardware resources. Time delay, complex, and dynamic relationships are present in the overall structure. The overall service quality of facilities is one of the most important factors in facilities’ development and that the skills of administrative and medical care personnel is the main critical factor in improving overall service quality. Finally, some suggestions are discussed relevant strategies for the government and the industry.

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References

  1. Anaf S., Drummond C., Sheppard L.A.: Combining case article research and systems theory as a heuristic model. Qual. Health Res. 17(10), 1309–1315 (2007)CrossRefGoogle Scholar
  2. Bharanitharan K., Ding J.R.: Bed status detection system for elder care center. ICL Tech. J. 129, 69–75 (2009)Google Scholar
  3. Castle N.G.: Nursing homes with persistent deficiency citations for physical restraint use. Med. Care 40(10), 868–878 (2002)CrossRefGoogle Scholar
  4. Chen, H.T.: The supply analysis for LTC resource. The international conference on the change and innovation trend of Social and health policy: march toward multi and integrate welfare system. 1–10 (2005)Google Scholar
  5. Chen H.M., Chang H.J.: Factors associated with quality of life in a group of dependent elders using home care services. J. LTC 11(3), 247–265 (2007)Google Scholar
  6. Chiou C.J., Yang M.S., Chen C.H.: Vision of long term care–a family-centered geriatric care. J. LTC 7(4), 386–398 (2004)Google Scholar
  7. Chiu M.J., Chen Y.M., Li H.P.: Life adaptation and the factors influencing it among the elderly living in LTC facilities. J. Evidence-Based Nurs. 3(2), 119–128 (2007)Google Scholar
  8. Dangerfield B.C.: System dynamics applications to European health care issues. J. Oper. Res. Soc. 50(4), 345–353 (1999)Google Scholar
  9. Department of Statistics of Ministry of the Interior. http://www.moi.gov.tw/stat/ (2010). Accessed 15 Nov 2010
  10. Executive Yuan, Taiwan. http://www.ey.gov.tw/ (2006). Accessed 15 Sept 2006
  11. Forrester J.W.: Industrial Dynamics. Productivity Press, Cambridge (1961)Google Scholar
  12. Gohlke J.M., Portier C.J.: The forest for the trees: a systems approach to human health research. Environ. Health Perspect. 115(9), 1261–1263 (2007)CrossRefGoogle Scholar
  13. Ho, C.F.: The current status of Health care serviceá1industry. Department of Industrial Technology of Ministry of Economics Affairs, Taiwan, p. 5 (2007)Google Scholar
  14. Homer J.B., Hirsch G.B.: System dynamics modeling for public health: background and opportunities. Am. J. Public Health 96(3), 452–458 (2006)CrossRefGoogle Scholar
  15. Hsiao C.T., Huang H.H.: A system dynamics model for technology development of Chinese herbal medicine industry in Taiwan. Taiwan Bus. Perform. J. 19(2), 129–145 (2008)Google Scholar
  16. Hudgson N., Freedman V.A., Granger D.A., Emo A.: Biobehavioral correlates of relocation in the frail elderly. Salivary cortisol, affect, and cognitive function. Am. Geriatr. Soc. 52(11), 1856–1862 (2004)CrossRefGoogle Scholar
  17. Jan T.S., Hsiao C.T.: A four-role model of the automotive industry development in developing countries: a case in Taiwan. J. Oper. Res. Soc. 55(11), 1145–1155 (2004)CrossRefGoogle Scholar
  18. Jan T.S., Chen H.H.: Systems approaches for the industrial development of a developing country. Syst. Pract. Action Res. 18(4), 365–377 (2005)CrossRefGoogle Scholar
  19. Keefe J., Fancey P.: The care continues: responsibility for elderly relatives before and after admission to a long term care facility. Fam. Relat. 49(30), 235–244 (2000)CrossRefGoogle Scholar
  20. Kitchener M., Harrington C.: The U.S. LTC field: a dialectic analysis of institution dynamics. J. health Soc. Behav. 45, 87–101 (2004)Google Scholar
  21. Lee M.H., Chiang H.C., Hwu Y.J.: The evolution of quality care indicators in LTC institutions. J. LTC 12(1), 32–41 (2008)Google Scholar
  22. Lowe B.F.: Directions for community-based LTC research. Milbank Q. 66(3), 552–571 (1998)CrossRefGoogle Scholar
  23. Lu, H.H.: Health care industry. Commercial Times. 2009.5.1 (2009)Google Scholar
  24. Marie Elf, Mariya P., Lena vk, Kerstin O.: Using system dynamics for collaborative design: a case study. BMC Health Serv. Res. 7, 123 (2007)CrossRefGoogle Scholar
  25. Mor V.: Improving the quality of LTC with better information. Milbank Q. 83(3), 333–364 (2005)CrossRefGoogle Scholar
  26. Nay R.: Nursing home residents’ perceptions of relocation. J. Clin. Nurs. 4(5), 319–325 (1995)CrossRefGoogle Scholar
  27. O’Connor B.P., Vallerand R.J.: Psychological adjustment variables as predictors of mortality among nursing home residents. Psychol. Aging 13(3), 368–374 (1998)CrossRefGoogle Scholar
  28. Pai J.Y., Yu S.H., Zeng S.H., Lai L.N., Huang K.K., Hsieh J.T.: Improve quality of healthcare by applying ISO to hospital work environment. Chung Shan Med J. 19(2), 175–185 (2008)Google Scholar
  29. Rauner M.S., Schaffhauser-Linzatti M.M.: Impact of the new Austrian inpatient payment strategy on hospital behavior: a system-dynamics model. Socio Econ. Plan. Sci. 36(3), 161–182 (2002)CrossRefGoogle Scholar
  30. Reed J., Morgan D.: Discharging older people from hospital to care homes: implications for nursing. J. Adv. Nurs. 29(4), 819–825 (1999)CrossRefGoogle Scholar
  31. Schuster M.A., McGlynn E.A., Brook R.H.: How good is the quality of health care in the United States?. Milbank Q. 76(4), 517–563 (1998)CrossRefGoogle Scholar
  32. Senge P.M.: The Fifth Discipline: The Art And Practice Of The Learning Organization. Doubleday, New York (1990)Google Scholar
  33. Somers A.R.: Long term care or the elderly and disabled, a new health priority. N. Engl. J. Med. 307, 221–225 (1982)CrossRefGoogle Scholar
  34. The Ministry of the Interior. http://www.moi.gov.tw/english/ (2008). Accessed 15 Nov 2008
  35. The Ministry of the Interior. http://www.moi.gov.tw/english/ (2009). Accessed 15 Aug 2009
  36. Tu, M.C.H.: Culture and job satisfaction: A comparative analysis between Taiwanese and Filipino caregivers working in Taiwan’s long term care industry. H. Wayne Huizenga School of Business and Entrepreneurship, Nova Southeastern Univ. Doctor dissertation. 2–3 (2006)Google Scholar
  37. Wang W.L., Chang H.J., Liu A.C., Chen Y.W.: Research into care quality criteria for LTC institutions. J. Nurs. Res. 15(4), 255–264 (2007)CrossRefGoogle Scholar
  38. Wu S.C., Chiang T.L.: LTC in Taiwan: issues and directions. Chin. J. Public Health 14(3), 246–255 (1995)Google Scholar
  39. Wu S.C., Dai U.T., Chuang K.U., Chang M., Lu P.C., Tsao A.L., Wang C.G., Chen C.F.: A pilot program for the development of LTC system-concepts and practices. Taiwan J. Public Health 23(3), 49–258 (2004)Google Scholar
  40. Yang H.J., Lu K.Y., Chen Y.C., Chang Y.Y.: Health status and LTC need of elderly in the community who live alone. J. Nurs. Res. 2(3), 229–240 (2006)Google Scholar
  41. Young H.M.: The transition of relocation to a nursing home. Holist. Nurs. Pract. 4(3), 76–83 (1990)Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Department of EconomicsTunghai UniversityTaichungTaiwan
  2. 2.Ph.D. Program in BusinessFeng Chia UniversityTaichungTaiwan
  3. 3.Department of Marketing and LogisticsChina University of TechnologyHsin-Chu HsienTaiwan
  4. 4.Hsin-Chu HsienTaiwan

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