Mapping the Global Landscape of Long-Term Care Insurance Research: A Scientometric Analysis

Nutritional status of the older adults in nursing homes: A cross-sectional study

AIM AND OBJECTIVES

To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses.

BACKGROUND

Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors.

DESIGN

A cross-sectional study.

METHODS

From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1).

RESULTS

209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment.

CONCLUSION

Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status.

PUBLIC CONTRIBUTION

This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.

Strategic assessment model of smart stadiums based on genetic algorithms and literature visualization analysis: A case study from Chengdu, China

This paper leverages Citespace and VOSviewer software to perform a comprehensive bibliometric analysis on a corpus of 384 references related to smart sports venues, spanning from 1998 to 2022. The analysis encompasses various facets, including author network analysis, institutional network analysis, temporal mapping, keyword clustering, and co-citation network analysis. Moreover, this paper constructs a smart stadiums strategic assessment model (SSSAM) to compensate for confusion and aimlessness by genetic algorithms (GA). Our findings indicate an exponential growth in publications on smart sports venues year over year. Arizona State University emerges as the institution with the highest number of collaborative publications, Energy and Buildings becomes the publication with the most documents. While, Wang X stands out as the scholar with the most substantial contribution to the field. In scrutinizing the betweenness centrality indicators, a paradigm shift in research hotspots becomes evident-from intelligent software to the domains of the Internet of Things (IoT), intelligent services, and artificial intelligence (AI). The SSSAM model based on artificial neural networks (ANN) and GA algorithms also reached similar conclusions through a case study of the International University Sports Federation (FISU), building Information Modeling (BIM), cloud computing and artificial intelligence Internet of Things (AIoT) are expected to develop in the future. Three key themes developed over time. Finally, a comprehensive knowledge system with common references and future hot spots is proposed.

Influences of long-term care insurance on pulmonary and urinary tract infections among older people with disability

BACKGROUND

Pulmonary infection (PI) and urinary tract infection (UTI) have been the most common cause of hospitalization and most frequent infection respectively in older people with disability (OPWD). Long-term care insurance (LTCI) policy, intending to provide services to reduce the disease burden of OPWD, it remains unclear whether LTCI could reduce PI-, and UTI-related hospitalizations. This quasi-experimental study aimed to assess the influences of LTCI on all-cause, especially PI- and UTI-related hospitalizations among OPWD and the variation across sociodemographic characteristics.

METHODS

32,120 participants in the Chengdu Long-term Care Insurance cohort were considered the intervention group, and 2,704 not covered by the LTCI were in the control group. A total of 3,134,160 hospitalization records were collected between January 2014 and June 2021. A doubly robust difference-in-differences (DID) method was used to estimate the average treatment effect on the treated (ATT), indicating the average effect of LTCI on intervention group.

RESULTS

The average monthly all-cause, PI-, and UTI-related hospitalization rates were 16.3%, 4.0% and 0.5% in the intervention group, respectively, and were 19.3%, 3.9% and 0.5% in the control group, respectively. Under LTCI, all-cause (ATT [95% CI]: 7.15% [6.41%, 7.88%]), PI- (3.25% [2.76%, 3.74%]), and UTI-related hospitalizations (0.46% [0.28%, 0.64%]) were decreased. The influences of LTCI became significant after 5 months since the LTCI implementation and remained stable over time. The impact was more pronounced among those with longer coverage. The overall reduction was stronger in those who were not married, lived alone, and resided in institutions.

CONCLUSIONS

LTCI may reduce the occurrence of all-cause, PI-, and UTI-related hospitalizations in OPWD, with stronger influences observed over an extended period of implementation. The implementation of LTCI can play a role in reducing the burden of infectious diseases in OPWD and the care burden of families and society.

The effect of long-term care insurance on healthcare utilization of middle-aged and older adults: evidence from China health and retirement longitudinal study

BACKGROUND

As global ageing continues to increase and many countries face challenges from the growing demand for long-term care. Drawing on the experiences of developed countries, developing countries have explored their own suitable long-term care insurance and have shown strong potential for development and research prospects. However, due to their late start, relevant research is underrepresented in the global research network and still needs to be supplemented. The present study hopes to examine the effect of long-term care insurance on healthcare utilization among the middle-aged and elderly from an empirical perspective, using China as an example.

METHODS

Panel data from wave 3 (2015) and wave 4 (2018) of the nationally-representative China health and retirement longitudinal study were selected to obtain a sample of 661 processing participants and 16,065 control participants after matching the policy implementation time in the first pilot cities, and quantitative analysis was conducted using difference-in-differences propensity score matching estimator method to assess the net effect of long-term care insurance on health care utilization among the middle-aged and elderly adults.

RESULTS

In the matched frequency-weighted regression difference-in-differences estimator results, long-term care insurance had a negative effect on the number and costs of annual hospitalizations at the 5% significance level (key variable values of - 0.0568101 and - 1236.309, respectively) and a non-significant effect on outpatient service utilization (P > 0.05). Further exploration of the heterogeneous effect of it revealed that implementation had a more significant negative effect on hospitalization utilization for middle-aged and older people in the East and for those with higher levels of education or attended care.

CONCLUSION

Long-term care insurance has played a role in controlling hospitalization costs but has not yet achieved the expected effect in controlling outpatient costs. The policy effects in terms of regional distribution and education level and care situation have been variable. The treatment plan of long-term care insurance needs to be improved, the supply of resources for long-term care services should be increased, and the promotion of long-term care insurance and health science should be given attention.

Comparative Analysis of Long-Term Care in OECD Countries: Focusing on Long-Term Care Financing Type

This study aims to examine the characteristics of long-term care (LTC) financing in Organization for Economic Cooperation Development (OECD) countries. To this end, the 26 OECD countries that have introduced LTC systems were classified into three types of models: tax-based, health insurance, and LTC insurance (LTCI) systems. Thereafter, these systems were analyzed using Gilbert and Terrell's policy analysis framework. The results indicated differences in the characteristics of each type of financing in terms of allocation, benefit provision, service delivery, and finance. It is likely that while the LTC insurance model was mainly based on universalism and showed the highest level of coverage, the tax-based and health insurance models adopted selectivism with lower level of benefits per capita. In terms of service delivery, local authorities tended to have the responsibility to decide LTC service users and provide services in many countries, regardless of the type of model. In terms of finance, LTC insurance-based countries had the highest LTC expenditure as a percentage of GDP, followed by countries with tax-based and health insurance systems.

A Bibliometric Analysis on Conservation Land Trust and Implication for China

Modern land protection and biodiversity conservation depend greatly on the application of land trust. With the accelerated development of land trust organizations, the land trust has become the most effective land conservation method. Land trusts have been widely used in the ecological protection of nature reserves abroad and have achieved remarkable results. The research on international land trusts has important reference value for the innovation of ecological protection models of China's nature reserves. This study aims to explore the research hotspots of international land trust conservation, clarify the evolution of related knowledge, and provide a reference for domestically related theoretical research and practical work. The research results show the following: (1) From the perspective of the publication trend, the number of international research publications increased exponentially from 1997 to 2021, and the research involves a wide range of disciplines. (2) In terms of research hotspots, land trust and private land protection, the impact of and response to climate change, and the trust mechanism in collaborative governance constitute three hot research topics. (3) From the knowledge base of the research, the international land trust research has formed seven knowledge clusters with clear boundaries, and five key documents with the theme of conservation easements constitute an important knowledge base in this field. (4) Land trust conservation easement as private law can effectively make up for the deficiency of public law. These findings can provide help and reference for domestic land conservation, as well as the reform of China's ecological civilization system.