Evolutionary game analysis of community elderly care service regulation in the context of "Internet +"

Evolutionary game analysis of building a sustainable intelligent elderly care service platform

With the rapid aging of populations and advancements in information technology, the development of intelligent elder-care service platforms (IESPs) has gained momentum. This paper examines the feasibility and strategies for constructing an IESP. Unlike commercial internet platforms, IESP facilitates transactions in elderly care services, which are quasi-public goods requiring government guidance and multi-stakeholder collaboration. Utilizing value co-creation theory, this study constructs a tripartite evolutionary game model involving a digital technology company, a social organization, and an elderly care service provider to analyze factors influencing stakeholder behavior. The findings reveal that sustained value co-creation is influenced by platform revenue, participation costs, reputation effects, and government subsidies. To optimize outcomes, the government should balance stakeholder interests, ensure reasonable profits for the digital company and social organization, and reduce participation costs through grassroots mobilization, data support, and subsidies for digital transformation. Strengthening reputation management and standardizing service evaluations are also crucial for achieving system equilibrium.

Effectiveness of King's Theory of Goal Attainment in Blood Glucose Management for Newly Diagnosed Patients With Type 2 Diabetes: Randomized Controlled Trial

BACKGROUND

Diabetes poses a significant public health challenge in China and globally, with the number of patients expected to reach 592 million by 2035, notably in Asia. In China alone, an estimated 140 million individuals are living with diabetes, and a significant portion is nonadherent to medications, underscoring the urgency of effective management strategies. Recognizing the necessity of early and comprehensive management for newly diagnosed patients with type 2 diabetes, this study leverages an online teach-back method and "Internet + Nursing" platform based on King's Theory of Goal Attainment. The approach aims to enhance glycemic control and reduce fear and misconceptions about the disease, addressing both the educational and emotional needs of the patients.

OBJECTIVE

The primary aim of this study was to assess the effectiveness of King's Goal Attainment Theory in the management of newly diagnosed patients with type 2 diabetes. This research sought to develop a collaborative model for blood glucose management, integrating the expertise and roles of physicians, nurses, and patients. The model is designed to enhance the synergy in health care provision, ensuring a comprehensive approach to diabetes management.

METHODS

In this study conducted at Changzhou Traditional Chinese Medicine Hospital between January 2022 and February 2023, eligible patients were randomized into a control group or an online feedback group. The control group received standard care, while the online feedback group participated in a King's Theory of Goal Attainment-based online teach-back program, enhanced by "Internet + Nursing" strategies. This included an interactive platform for goal planning, video content sharing, comprehension assessment, misconception correction, and patient-driven recaps of disease information. Health monitoring was facilitated through the "Internet + Nursing" platform. The study focused on comparing changes in glucose metabolism and emotional disorder symptoms between the groups to evaluate the intervention's effectiveness.

RESULTS

Following a 24-week intervention, we observed significant differences in key metrics between the online feedback group and the control group, each comprising 60 participants. The online feedback group demonstrated significant reductions in fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c (P<.05). Additionally, there was a notable decrease in hypoglycemia-related anxiety and alexithymia within this group. Conversely, the control group maintained relatively higher values for these metrics at the same time point (P<.05). These findings underscore the efficacy of online feedback in managing glycemic control and reducing psychological distress associated with hypoglycemia.

CONCLUSIONS

The online teaching-back method, guided by King's Theory of Goal Attainment, effectively enhances glycemic control, reducing fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c levels in newly diagnosed patients with type 2 diabetes. Simultaneously, it alleviates hypoglycemia-related anxiety and mitigates alexithymia. This approach merits widespread promotion and implementation in clinical settings.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2400079547; https://www.chictr.org.cn/showproj.html?proj=208223.

How do policies promote the sustainable development of older-adult care industry? A configuration analysis based on policy tools

Background

Under the background of population aging in China, the demand for older-adult care services and products is growing, and the older-adult care industry has great development prospects. A sound older-adult care policy system, that is, an effective policy tool mix, plays an important role in improving the sustainable development of older-adult care industry.

Materials and methods

Based on older-adult care policy documents from 31 Chinese provinces, this research extracts older-adult care policy tools via text mining. Then extracted policy tools are taken as conditional variables, and the development of older-adult care industry, which is manifested by the number of older-adult care companies across 31 regions is taken as the result variable. Through applying qualitative comparative analysis, the combined effect of different policy tools on the development of older-adult care industry is obtained.

Results and discussions

Results show that a single policy tool cannot constitute the necessary condition to facilitate the older-adult care industry. Hence, policy tools should be applied in combination. Five sustainable policy tool mixes which can promote the development of older-adult care industry are summarized, namely supporting policy-driven mode, fiscal and tax support mode led by supply-oriented policy tools, double-team mode driven by fiscal and tax support and the consumer market, multi-subject joint force mode, and technology compensation mode. The overall findings of this study imply that exploring the policy tool combinations is of vital importance to the sustainable development of older-adult care industry.

Smart transition pathways and development incentive mechanism of China's smart community elderly care industry under market dominance: Considering a multi-subjective behavior game

Against the backdrop of an aging population, China is actively experimenting with an innovative elderly care model, so smart community elderly care has recently received widespread attention. However, the results of the implementation of the model have not yet met the expectation due to the variety of interests among the relevant participants. In this study, we identified the most core stakeholders in smart community elderly care, developed a four-party evolutionary game model including local governments, communities, service supply enterprises and households with elderly members. By applying the system dynamics method, we simulate the evolutionary paths and explore the complex interactions at the multiparticipant level in order to facilitate the transition of community elderly care services from traditional to smart, and then propose managerial insights for accelerating the construction of smart community elderly care. The results suggest that: (1) the four players in the game influence each other and are intimately related, and the benign interaction between them will further stimulate the vitality of the smart community elderly care industry; (2) appropriate improvement in policy support will strongly promote smart community elderly care, and the incentive effect on the demand side (households with elderly members) is more significant; (3) when households' preference for smart services increases, and the perceived value to communities and enterprises reaches a certain threshold, communities and enterprises will actively adopt smart solution and technology as well as develop stable portfolio strategy; (4) measures such as simultaneously increasing the level of smart and resource synergy will promote the system evolution toward smart services, and the system is more sensitive to the internal behavior of the enterprise than the external behavior between community and enterprise.

Study on the measurement of coupling and coordinated development level between China's internet and elderly care services and its influencing factors

BACKGROUND

With the intensification of China's aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services.

METHODS

In this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services.

RESULTS

(1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of "disorder recession-transition coordination-coordinated development". (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services.

CONCLUSION

In order to promote the coordinated development of China's Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China's Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China's Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China.

Evolutionary game and stability analysis of elderly care service quality supervision from the perspective of government governance

Objective

The performance of government functions is an important guarantee for the standardized operation of the elderly service market. The objective of this study is to explore the optimal path for the government to govern the elderly care service market.

Methods

The tripartite evolutionary game model is proposed in the paper, which composed of local governments, private elderly care institutions and the public. Furthermore, three mechanisms, i.e. dynamic penalty and static subsidy, static penalty and dynamic subsidy, dynamic penalty and dynamic subsidy, are designed. Under these different mechanisms, the stability of each subject's strategy choice is analyzed by using system dynamics simulation.

Results

The introduction of dynamic mechanisms can compensate for the inability of static mechanisms to bring the system to a steady state. The dynamic penalty and dynamic subsidy mechanism allows the system to evolve to the desired point of stability. The self-discipline behavior of private elderly care institutions is positively correlated with penalties and reputation gains-losses, negatively correlated with subsidies, and not correlated with supervision rewards. Excessive subsidies will promote the collusion of private elderly institutions.

Conclusion

Only when the local government adopts the dynamic penalty and dynamic subsidy mechanism will private elderly care institutions choose to operate in a fully self-disciplined manner. Reasonable adjustments of penalties, reputation gains-losses and subsidies can not only further optimize the dynamic penalty and dynamic subsidy mechanism, but also help to achieve diversified regulatory objectives of the government. This study would provide a reference for local governments seeking to develop effective regulatory policies for the elderly service market.