Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

PURPOSE: This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. DESIGN: A cross-sectional design was used. METHODS: A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. FINDINGS: Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. CONCLUSIONS: Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. CLINICAL RELEVANCE: Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

The development of quality indicators for home care in China.

OBJECTIVES: To develop a comprehensive system of quality indicators for home care in China. DESIGN: A modified Delphi technique and analytic hierarchy process. PARTICIPANTS: Twenty experts were invited to participate in the Delphi expert consultation. METHODS: Experts rated the perceived importance of 92 potential indicators through two rounds of e-mail surveys in November and December 2016. The analytic hierarchy process was used to determine the relative importance of the quality indicators identified through the Delphi expert consultation. RESULTS: The average authoritative coefficient was 0.815 ± 0.0432 (range: 0.75-0.90). After two rounds of Delphi expert consultation, 77 quality indicators were identified as important in the Chinese home care setting. The mean importance ratings ranged from 4.35 to 4.95 on a 5-point scale, with variation coefficients ranging from 0.04 to 0.15. The percentage of experts giving the maximum possible score on each item ranged from 45% to 95%. In the second round, the Kendall's W coefficients ranged from 0.363 to 0.570. As for relative importance, the weights were 0.198-0.490, 0.029-0.047 and 0.037-0.66 for first-level, secondary-level and third-level quality indicators, respectively, with all consistency ratio values less than 0.1. CONCLUSION: The absolute and relative importance of 77 indicators identified as potentially valid measures of the quality of Chinese home care was determined. This instrument is the first set of home care quality indicators developed specifically for mainland China, and it should be useful in evaluating and improving the quality of Chinese home care.