International Journal of Integrated Care, 21(2), 2021, p.1. Online only
Publisher:
International Foundation for Integrated Care
... health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care. Conclusions and discussion: Doctor and hospital-based healthcare delivery system requires more
(Edited publisher abstract)
Introduction: Japan’s health policies to address the most advanced-aged society have been the target of focus in Asia, but no studies have investigated this issue using tools for cross-country comparisons. Theory and methods: A cross-country study design was used to compare healthcare reform policies with a framework in Japan, Korea, Thailand, China, Indonesia, and the Philippines. Data were collected via document reviews and key informant interviews. Results: Three distinctions were identified. First, all countries except for the Philippines have policy decisions regarding reforms for the existing service delivery systems for healthcare, long-term care and welfare. Second, the most extensive service delivery reform is currently being implemented in Japan, whose system is shifting to primary health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care. Conclusions and discussion: Doctor and hospital-based healthcare delivery system requires more drastic reform for an aged society. This fact implies that strengthening primary health care is not only useful for current health issues but also an investment for the aged society near future in low- and middle-income countries.
(Edited publisher abstract)
Subject terms:
comparative studies, older people, ageing, service provision, care reform, integrated care, health care;
Content type:
research
Location(s):
Japan, South Korea, China, Thailand, Indonesia, Philippines
Ageing and Society, 26(1), January 2006, pp.37-60.
Publisher:
Cambridge University Press
Contemporary trends in population ageing and urbanisation in the developing world imply that the extensive out-migration of young people from rural areas coincides with, and is likely to exacerbate, a rise in the older share of the rural population. This paper examines the impact of migration on vulnerability at older ages by drawing on the results of anthropological and demographic field studies
Contemporary trends in population ageing and urbanisation in the developing world imply that the extensive out-migration of young people from rural areas coincides with, and is likely to exacerbate, a rise in the older share of the rural population. This paper examines the impact of migration on vulnerability at older ages by drawing on the results of anthropological and demographic field studies in three Indonesian communities. The methodology for identifying vulnerable older people has a progressively sharper focus, beginning first with important differences between the communities, then examining variations by socio-economic strata, and finally the variability of older people's family networks. Comparative analysis indicates considerable heterogeneity in past and present migration patterns, both within and between villages. The migrants' contributions are a normal and important component of older people's support, often in combination with those of local family members. Higher status families are commonly able to reinforce their position by making better use of migration opportunities than the less advantaged. Although family networks in the poorer strata may effect some redistribution of the children's incomes, their social networks are smaller and insufficient to overcome their marked disadvantages. Vulnerability thus arises where several factors, including migration histories, result in unusually small networks, and when the migrations are within rural areas.
Most social research on ageing in Asia has focused on the support provided by adult children to their parents, and thereby suggests that as a matter of course older people are in need of support. This paper offers a different perspective. Drawing on ethnographic and quantitative data from a village in East Java, it examines the extent of older people's dependence on others and highlights
Most social research on ageing in Asia has focused on the support provided by adult children to their parents, and thereby suggests that as a matter of course older people are in need of support. This paper offers a different perspective. Drawing on ethnographic and quantitative data from a village in East Java, it examines the extent of older people's dependence on others and highlights the material and practical contributions that they make to their families. It is shown that only a minority of older people are reliant on children or grandchildren for their daily survival. In the majority of cases, the net flow of inter-generational support is either downwards – from old to young – or balanced. Far from merely assisting with childcare and domestic tasks, older people are often the economic pillars of multi-generational families. Pension and agricultural incomes serve to secure the livelihoods of whole family networks, and the accumulated wealth of older parents is crucial for launching children into economic independence and underwriting their risks. Parental generosity does not generally elicit commensurate reciprocal support when it is needed, leaving many people vulnerable towards the end of their lives.
Subject terms:
income, informal care, parents, rural areas, ageing, cultural identity, families, family relations;