PDF(Pubmed)
Abstract：
BACKGROUND: Government purchase of social forces to participate in old age care services can release the burden of social care. Current research on performance evaluation in this field mainly focussed on the establishment of appropriate evaluation indices. However, discussion on the policy implementation deviation is scarce. This study aimed to evaluate the performance of China\'s local government purchase of old age care services, analyse the characteristics of related policies and explore their deviation.
METHODS: The persons who participated in the Training of the Trainer (ToT) organized by the Red Cross Society were enrolled. The policy documents were obtained from the official websites. The K-means cluster was used to determine the project performance grades. We compared the project performance grades between service objects and undertakers with different characteristics utilizing the non-parametric test. Based on the framework of \'Collaborative Participation - Project Performance Objective\', we analysed the content of relevant policy aiding by NVivo 12.
RESULTS: Data of project performance were collected from 306 participants. The standardized mean score of the efficiency dimension was the lowest (0.70 ± 0.24). The projects were divided into four grades: poor (17.0%), average (27.5%), good (12.4%) and excellent (43.1%). There were statistically significant differences in project performance grades only between advanced ageing groups (Z = 2.429, P = 0.015). As well, the policy also mentioned that the services focus should be tilted towards the oldest old. The purchasers mainly involved the Ministry of Civil Affairs and Health management departments in the policy. Respite services were less mentioned in the responsibilities of the undertakers. The requirement for efficiency and effectiveness was mentioned in less than half of the policy documents.
CONCLUSIONS: Policy attention is needed for the responsibilities and functions of the intermediate purchasing force, as well as more precise directions and responsibilities of undertakers. The purchasers and undertakers should improve management abilities and capacity of old age care services and focus on associated factors to achieve the best marginal benefit. In addition, the embedded performance evaluation needs to be updated periodically to bridge the deviation between policy implementation and policy formulation.
METHODS: The persons who participated in the Training of the Trainer (ToT) organized by the Red Cross Society were enrolled. The policy documents were obtained from the official websites. The K-means cluster was used to determine the project performance grades. We compared the project performance grades between service objects and undertakers with different characteristics utilizing the non-parametric test. Based on the framework of \'Collaborative Participation - Project Performance Objective\', we analysed the content of relevant policy aiding by NVivo 12.
RESULTS: Data of project performance were collected from 306 participants. The standardized mean score of the efficiency dimension was the lowest (0.70 ± 0.24). The projects were divided into four grades: poor (17.0%), average (27.5%), good (12.4%) and excellent (43.1%). There were statistically significant differences in project performance grades only between advanced ageing groups (Z = 2.429, P = 0.015). As well, the policy also mentioned that the services focus should be tilted towards the oldest old. The purchasers mainly involved the Ministry of Civil Affairs and Health management departments in the policy. Respite services were less mentioned in the responsibilities of the undertakers. The requirement for efficiency and effectiveness was mentioned in less than half of the policy documents.
CONCLUSIONS: Policy attention is needed for the responsibilities and functions of the intermediate purchasing force, as well as more precise directions and responsibilities of undertakers. The purchasers and undertakers should improve management abilities and capacity of old age care services and focus on associated factors to achieve the best marginal benefit. In addition, the embedded performance evaluation needs to be updated periodically to bridge the deviation between policy implementation and policy formulation.
摘要：
背景：政府购买社会力量参与养老服务可以减轻社会养老负担。当前该领域对绩效评估的研究主要集中在建立适当的评估指标上。然而,关于政策执行偏差的讨论很少。本研究旨在评价我国地方政府购买养老服务的绩效,分析相关政策的特点，探讨其偏差。
方法：参加了红十字会组织的培训师培训（ToT）的人员。政策文件是从官方网站获得的。K均值聚类用于确定项目绩效等级。我们使用非参数检验比较了服务对象和具有不同特征的承担者之间的项目绩效等级。基于“协作参与-项目绩效目标”的框架，我们分析了NVivo12的相关政策援助内容。
结果：收集了306名参与者的项目绩效数据。效率维度的标准化平均得分最低(0.70±0.24)。项目分为四个等级：差（17.0％），平均(27.5%)，良好（12.4%）和优秀（43.1%）。仅在高级老龄化组之间，项目绩效等级差异有统计学意义（Z=2.429，P=0.015）。同样,该政策还提到，服务重点应该向最古老的老年人倾斜。购买者主要涉及民政部和卫生管理部门的政策。承办人的责任中很少提到暂缓服务。不到一半的政策文件提到了效率和效力的要求。
结论：需要对中间采购力量的职责和职能给予政策关注，以及承办人更精确的方向和责任。购买者和承担者应提高养老服务的管理能力和能力，并关注相关因素，以实现最佳边际效益。此外,嵌入式绩效评估需要定期更新，以弥合政策执行和政策制定之间的偏差。
方法：参加了红十字会组织的培训师培训（ToT）的人员。政策文件是从官方网站获得的。K均值聚类用于确定项目绩效等级。我们使用非参数检验比较了服务对象和具有不同特征的承担者之间的项目绩效等级。基于“协作参与-项目绩效目标”的框架，我们分析了NVivo12的相关政策援助内容。
结果：收集了306名参与者的项目绩效数据。效率维度的标准化平均得分最低(0.70±0.24)。项目分为四个等级：差（17.0％），平均(27.5%)，良好（12.4%）和优秀（43.1%）。仅在高级老龄化组之间，项目绩效等级差异有统计学意义（Z=2.429，P=0.015）。同样,该政策还提到，服务重点应该向最古老的老年人倾斜。购买者主要涉及民政部和卫生管理部门的政策。承办人的责任中很少提到暂缓服务。不到一半的政策文件提到了效率和效力的要求。
结论：需要对中间采购力量的职责和职能给予政策关注，以及承办人更精确的方向和责任。购买者和承担者应提高养老服务的管理能力和能力，并关注相关因素，以实现最佳边际效益。此外,嵌入式绩效评估需要定期更新，以弥合政策执行和政策制定之间的偏差。
