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Residential Care for Frail and Marginalised Older People in Hong Kong 1990-2006: targeting and efficiency?

CHOW, Kit Ling Lina (2015) Residential Care for Frail and Marginalised Older People in Hong Kong 1990-2006: targeting and efficiency? Doctor of Philosophy (PhD) thesis, University of Kent,. (KAR id:48992)

Abstract

Rapid growth in the number and proportion of older people in Hong Kong is shown to have taken place since the late nineties. The substantial increase in the number of older people (particularly the old-olds) and their declining ability levels accelerated the need for long-term care, including residential care. This has exerted heavy financial pressure on the government. Subsequently a new policy - the ‘Standardised Care Need Assessment Mechanism’ (SCNAM) - for elderly services was introduced in November 2000; giving rise to both intended and unintended consequences.

Efficiency is judged not by cost per person alone, but by the ratios of costs to outcomes. Findings in the study show that the quality of publicly-funded residential care in Hong Kong fell over the period, and this evidence puts any suggestion of greater efficiency in doubt. Most importantly, the quality of life of residents has been adversely affected and this is an ‘unintended consequence’ that needs to be taken into account by the policy-makers.

Throughout its recent history Hong Kong has adopted a residual model of welfare, in which the government’s paramount focus has been on economic development. This is clearly reflected in the provision and financing of long-term residential care homes as operated under ‘a mixed economy of welfare’ system, in which the government only assumes a role as a funder. Other crucial issues such as the quality of care by front-line personal care staff as well as the quality of life of residents are largely outside of its policy concerns. Current evidence shows that better targeting and lower unit costs have been achieved in the two Care Homes of the Helping Hand, but at the expense of the effectiveness of care. The policy shift has produced new winners and losers. A focus on controlling the costs of public support for older people amounts to what Titmuss (1968, p.133) called a price that some pay ‘for the costs of other people’s progress’.

Item Type: Thesis (Doctor of Philosophy (PhD))
Thesis advisor: Baldock, John C.
Uncontrolled keywords: Long-term care, social policy, older people, efficiency, care homes
Subjects: H Social Sciences
H Social Sciences > HN Social history and conditions. Social problems. Social reform
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Depositing User: Users 1 not found.
Date Deposited: 10 Jun 2015 09:00 UTC
Last Modified: 29 May 2019 14:42 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/48992 (The current URI for this page, for reference purposes)
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