A Pilot Study on the Satisfaction of Long-Term Care Services in Taiwan
Abstract
:1. Introduction
2. Literature Review
2.1. Consumer Satisfaction and Quality of Healthcare Services
2.2. Long-Term Care Services
3. Data and Methods
3.1. Sampling and Data Collection
3.2. Variable Measurement
3.3. Method of Analysis: SEM-ANN Approach
4. Case Study
4.1. Statistical Data Analysis
4.2. Structural Equation Modeling (SEM)
4.3. Artificial Neural Network (ANN)
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Constructs | Indicators |
---|---|
A. Government support | A1. The government implements good regulations toward long-term care institutions. |
A2. The government needs to formulate more regulations for long-term care institutions. | |
A3. The government provides comprehensive support to long-term care recipients. | |
A4. The government should provide more funding for long-term care-related services. | |
A5. The government should promote long-term care insurance. | |
A6. The government should provide more community-based long-term care services. | |
A7. Providing government subsidies to long-term care recipients is the best way for caring them. | |
A8. The government should promote more long-term care related programs. | |
B. Long-term care service providers | B1. Long-term care institutions charge reasonable fees. |
B2. The charging standards of long-term care institutions do not need to be unified. | |
B3. Long-term care institutions need to arrange staff training and education in a timely basis. | |
B4. Long-term care institutions have the right to choose the person to be cared for. | |
B5. Long-term care institutions need to provide a family meeting space for family members when visiting the care recipients. | |
B6. Long-term care institutions need to provide different care methods for different care recipients. | |
B7. The environment of long-term care institutions is very important. | |
C. Services received by elderly and family | C1. Group activities should be held for the elderly regularly. |
C2. Outdoor activities should be provided for the elderly in a timely and regular manner. | |
C3. Single room can be provided for the elderly if preferred. | |
C4. Senior daycare centers need to provide transportation services. | |
C5. Violating the regulations of caring for the elderly should be fined strictly. | |
D. Public attitude toward long-term care | D1. I understand the long-term care plan 2.0. |
D2. If I need to choose a long-term care institution, I will choose a suburban area. | |
D3. I think the elderly care resources in Taiwan are sufficient at present. | |
D4. I agree with the government’s promotion of community-based long-term care services. | |
D5. I think the current long-term care workforce is sufficient. | |
D6. I think the government can afford the financial expenditures of the long-term care support. | |
D7. I think it is inconvenient to use long-term care resources in remote areas. | |
D8. I am willing to enter long-term care related industries. | |
D9. If one day I need long-term care, I will choose home care because my home is more familiar and comfortable. | |
S. Satisfaction of long-term care services | S1. I am satisfied with the fees charged by the general long-term care institutions. |
S2. I am satisfied with the government’s long-term care subsidies received by the long-term care institutions. | |
S3. I am satisfied with Taiwan’s current long-term care policy. | |
S4. I am satisfied with the locations of current long-term care institutions in Taiwan. | |
S5. I am satisfied with Taiwan’s current long-term care services. | |
S6. I am satisfied with the environment of current long-term care institutions in Taiwan. | |
S7. I am satisfied with current services received by long-term care recipients in Taiwan. |
Characteristics | Categories | Number of Responses | Percentage |
---|---|---|---|
Gender | Male | 207 | 50.12% |
Female | 206 | 49.88% | |
Age | Below 20 | 17 | 4.12% |
20–29 | 131 | 31.72% | |
30–39 | 26 | 6.30% | |
40–49 | 98 | 23.73% | |
50–59 | 135 | 32.69% | |
Over 60 | 6 | 1.45% | |
Education level | Elementary school | 3 | 0.73% |
Middle school | 19 | 4.60% | |
High school | 65 | 15.74% | |
Undergraduate | 271 | 65.62% | |
Graduate | 55 | 13.32% |
Component | |||||
---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | |
A1 | 0.203 | 0.858 | 0.106 | 0.064 | 0.103 |
A2 | 0.251 | 0.735 | 0.130 | 0.073 | −0.021 |
A3 | 0.236 | 0.862 | 0.063 | 0.053 | 0.081 |
A4 | 0.292 | 0.757 | 0.112 | 0.139 | 0.001 |
A5 | 0.266 | 0.902 | 0.113 | 0.058 | 0.030 |
A6 | 0.253 | 0.814 | 0.118 | 0.137 | 0.010 |
A7 | 0.215 | 0.825 | 0.142 | 0.043 | −0.011 |
A8 | 0.257 | 0.833 | 0.074 | 0.020 | 0.038 |
B1 | 0.132 | 0.126 | 0.881 | 0.295 | 0.019 |
B2 | 0.121 | 0.131 | 0.857 | 0.324 | −0.018 |
B3 | 0.125 | 0.108 | 0.895 | 0.296 | 0.002 |
B4 | 0.053 | 0.152 | 0.784 | 0.213 | 0.159 |
B5 | 0.102 | 0.125 | 0.846 | 0.237 | 0.048 |
B6 | 0.127 | 0.125 | 0.793 | 0.271 | 0.070 |
B7 | 0.122 | 0.083 | 0.854 | 0.245 | 0.013 |
C1 | 0.100 | 0.054 | 0.038 | 0.105 | 0.913 |
C2 | 0.119 | 0.043 | 0.086 | 0.157 | 0.883 |
C3 | 0.141 | 0.051 | −0.017 | 0.088 | 0.899 |
C4 | 0.143 | 0.019 | 0.040 | 0.113 | 0.900 |
C5 | 0.178 | 0.000 | 0.063 | 0.117 | 0.882 |
D1 | 0.846 | 0.232 | 0.113 | 0.099 | 0.044 |
D2 | 0.907 | 0.218 | 0.104 | 0.142 | 0.123 |
D3 | 0.837 | 0.272 | 0.131 | 0.161 | 0.110 |
D4 | 0.908 | 0.226 | 0.108 | 0.121 | 0.087 |
D5 | 0.803 | 0.317 | 0.177 | 0.081 | 0.127 |
D6 | 0.707 | 0.384 | 0.015 | 0.134 | 0.234 |
D7 | 0.882 | 0.226 | 0.097 | 0.151 | 0.121 |
D8 | 0.821 | 0.219 | 0.124 | 0.168 | 0.064 |
D9 | 0.764 | 0.334 | 0.075 | 0.112 | 0.206 |
S1 | 0.764 | 0.078 | 0.320 | 0.769 | 0.208 |
S2 | 0.235 | 0.111 | 0.289 | 0.844 | 0.263 |
S3 | 0.184 | 0.100 | 0.325 | 0.803 | 0.250 |
S4 | 0.189 | 0.104 | 0.271 | 0.838 | 0.225 |
S5 | 0.184 | 0.109 | 0.306 | 0.757 | 0.058 |
S6 | 0.118 | 0.049 | 0.465 | 0.710 | −0.025 |
S7 | 0.113 | 0.068 | 0.447 | 0.722 | −0.063 |
Construct/Indicators | Mean | SD | Loadings | Cronbach’s α | CR | AVE |
---|---|---|---|---|---|---|
| 0.951 | 0.954 | 0.722 | |||
A1 | 4.57 | 1.308 | 0.881 | |||
A2 | 4.45 | 1.328 | 0.734 | |||
A3 | 4.61 | 1.291 | 0.910 | |||
A4 | 4.58 | 1.450 | 0.767 | |||
A5 | 4.69 | 1.345 | 0.968 | |||
A6 | 4.67 | 1.329 | 0.846 | |||
A7 | 4.73 | 1.342 | 0.822 | |||
A8 | 4.84 | 1.423 | 0.848 | |||
| 0.961 | 0.962 | 0.768 | |||
B1 | 4.74 | 1.445 | 0.974 | |||
B2 | 4.74 | 1.465 | 0.942 | |||
B3 | 4.77 | 1.436 | 0.975 | |||
B4 | 4.48 | 1.321 | 0.738 | |||
B5 | 4.75 | 1.400 | 0.827 | |||
B6 | 4.72 | 1.338 | 0.783 | |||
B7 | 4.81 | 1.461 | 0.866 | |||
| 0.951 | 0.953 | 0.801 | |||
C1 | 4.60 | 1.408 | 0.913 | |||
C2 | 4.81 | 1.364 | 0.884 | |||
C3 | 4.49 | 1.350 | 0.889 | |||
C4 | 4.67 | 1.392 | 0.907 | |||
C5 | 4.70 | 1.313 | 0.883 | |||
| 0.962 | 0.966 | 0.762 | |||
D1 | 4.99 | 1.130 | 0.883 | |||
D2 | 4.99 | 1.152 | 0.971 | |||
D3 | 4.92 | 1.195 | 0.877 | |||
D4 | 4.97 | 1.142 | 0.968 | |||
D5 | 4.94 | 1.191 | 0.826 | |||
D6 | 4.78 | 1.199 | 0.748 | |||
D7 | 4.99 | 1.180 | 0.939 | |||
D8 | 4.89 | 1.224 | 0.825 | |||
D9 | 4.75 | 1.217 | 0.789 | |||
| 0.943 | 0.945 | 0.714 | |||
S1 | 4.90 | 1.228 | 0.878 | |||
S2 | 4.96 | 1.180 | 0.966 | |||
S3 | 4.98 | 1.184 | 0.926 | |||
S4 | 4.91 | 1.166 | 0.962 | |||
S5 | 5.00 | 1.288 | 0.733 | |||
S6 | 4.97 | 1.192 | 0.691 | |||
S7 | 4.97 | 1.185 | 0.702 |
A | B | C | D | S | |
---|---|---|---|---|---|
A | 0.850 | ||||
B | 0.283 | 0.876 | |||
C | 0.135 | 0.117 | 0.895 | ||
D | 0.533 | 0.299 | 0.294 | 0.873 | |
S | 0.267 | 0.606 | 0.393 | 0.394 | 0.845 |
A | B | C | D | S | |
---|---|---|---|---|---|
A | |||||
B | 0.316 | ||||
C | 0.113 | 0.177 | |||
D | 0.599 | 0.375 | 0.318 | ||
S | 0.287 | 0.810 | 0.322 | 0.409 |
Indicator | Standardized Estimate | Unstandardized Estimate | Standard Error | Critical Ratio | p Value |
---|---|---|---|---|---|
A1 | 0.881 | 1.000 | |||
A2 | 0.736 | 0.848 | 0.045 | 18.727 | *** |
A3 | 0.909 | 1.018 | 0.036 | 28.260 | *** |
A4 | 0.770 | 0.969 | 0.048 | 20.156 | *** |
A5 | 0.967 | 1.128 | 0.034 | 32.872 | *** |
A6 | 0.848 | 0.977 | 0.041 | 24.047 | *** |
A7 | 0.822 | 0.957 | 0.042 | 22.756 | *** |
A8 | 0.848 | 1.047 | 0.043 | 24.177 | *** |
B1 | 0.974 | 1.000 | |||
B2 | 0.943 | 0.981 | 0.021 | 47.373 | *** |
B3 | 0.989 | 1.010 | 0.014 | 72.397 | *** |
B4 | 0.740 | 0.694 | 0.032 | 21.431 | *** |
B5 | 0.828 | 0.823 | 0.029 | 28.101 | *** |
B6 | 0.785 | 0.746 | 0.031 | 24.432 | *** |
B7 | 0.866 | 0.899 | 0.028 | 32.369 | *** |
C1 | 0.911 | 1.000 | |||
C2 | 0.885 | 0.941 | 0.033 | 28.182 | *** |
C3 | 0.889 | 0.935 | 0.033 | 28.595 | *** |
C4 | 0.906 | 0.982 | 0.033 | 30.016 | *** |
C5 | 0.884 | 0.904 | 0.032 | 27.878 | *** |
D1 | 0.883 | 1.000 | |||
D2 | 0.982 | 1.135 | 0.032 | 35.442 | *** |
D3 | 0.879 | 1.053 | 0.040 | 26.407 | *** |
D4 | 0.977 | 1.119 | 0.032 | 34.962 | *** |
D5 | 0.829 | 0.990 | 0.042 | 23.366 | *** |
D6 | 0.752 | 0.904 | 0.046 | 19.600 | *** |
D7 | 0.940 | 0.966 | 0.045 | 21.482 | *** |
D8 | 0.827 | 1.112 | 0.036 | 31.145 | *** |
D9 | 0.792 | 1.015 | 0.044 | 23.262 | *** |
S1 | 0.881 | 1.000 | |||
S2 | 0.984 | 1.073 | 0.031 | 35.015 | *** |
S3 | 0.927 | 1.016 | 0.034 | 29.961 | *** |
S4 | 0.961 | 1.036 | 0.032 | 32.734 | *** |
S5 | 0.736 | 0.877 | 0.046 | 18.850 | *** |
S6 | 0.697 | 0.768 | 0.044 | 17.294 | *** |
S7 | 0.705 | 0.773 | 0.044 | 17.631 | *** |
Goodness of Fit Measures | Recommended Value | Acceptable Value | CFA Model |
---|---|---|---|
χ2 statistics/df | 3.0 | 5.0 | 4.674 |
Normed fit index (NFI) | 0.90 | 0.85 | 0.864 |
Comparative fit index (CFI) | 0.90 | 0.85 | 0.889 |
Root mean square error of approximation (RMSEA) | 0.08 | 0.1 | 0.094 |
Goodness of Fit Measures | Recommended Value |
Acceptable Value | Structural Model |
---|---|---|---|
χ2 statistics/df | 3.0 | 5.0 | 4.723 |
Normed fit index (NFI) | 0.90 | 0.85 | 0.861 |
Comparative fit index (CFI) | 0.90 | 0.85 | 0.887 |
Root mean square error of approximation (RMSEA) | 0.08 | 0.1 | 0.095 |
Hypothesis | Construct | Standardized Estimate | Unstandardized Estimate | Standard Error | Critical Ratio | p Value | ||
---|---|---|---|---|---|---|---|---|
H1 | A | → | S | 0.001 | 0.001 | 0.041 | 0.025 | 0.980 |
H2 | A | → | D | 0.481 | 0.402 | 0.040 | 10.054 | *** |
H3 | B | → | S | 0.546 | 0.406 | 0.032 | 12.759 | *** |
H4 | B | → | D | 0.153 | 0.105 | 0.030 | 3.467 | *** |
H5 | C | → | S | 0.296 | 0.241 | 0.034 | 7.179 | *** |
H6 | C | → | D | 0.224 | 0.168 | 0.033 | 5.085 | *** |
H7 | D | → | S | 0.153 | 0.166 | 0.050 | 3.330 | *** |
Artificial Neural Networks | Model 1 Input Neurons: A, B, C Output Neuron: D | Model 2 Input Neurons: B, C, D Output Neuron: S | ||
---|---|---|---|---|
Training | Testing | Training | Testing | |
ANN1 | 0.114 | 0.109 | 0.101 | 0.098 |
ANN2 | 0.109 | 0.099 | 0.100 | 0.122 |
ANN3 | 0.117 | 0.120 | 0.104 | 0.092 |
ANN4 | 0.107 | 0.111 | 0.099 | 0.095 |
ANN5 | 0.117 | 0.098 | 0.101 | 0.084 |
ANN6 | 0.116 | 0.106 | 0.100 | 0.066 |
ANN7 | 0.106 | 0.112 | 0.109 | 0.095 |
ANN8 | 0.115 | 0.087 | 0.110 | 0.093 |
ANN9 | 0.107 | 0.094 | 0.106 | 0.090 |
ANN10 | 0.107 | 0.102 | 0.100 | 0.104 |
Mean | 0.112 | 0.104 | 0.103 | 0.094 |
Standard deviation | 0.005 | 0.010 | 0.004 | 0.014 |
Artificial Neural Networks | Model 1 Output Neuron: D | Model 2 Output Neuron: S | ||||
---|---|---|---|---|---|---|
A | B | C | B | C | D | |
ANN1 | 0.575 | 0.178 | 0.246 | 0.579 | 0.207 | 0.214 |
ANN2 | 0.548 | 0.155 | 0.298 | 0.555 | 0.199 | 0.245 |
ANN3 | 0.383 | 0.237 | 0.380 | 0.525 | 0.197 | 0.279 |
ANN4 | 0.520 | 0.178 | 0.303 | 0.523 | 0.214 | 0.163 |
ANN5 | 0.604 | 0.177 | 0.219 | 0.68 | 0.162 | 0.158 |
ANN6 | 0.485 | 0.254 | 0.262 | 0.599 | 0.223 | 0.177 |
ANN7 | 0.541 | 0.130 | 0.329 | 0.586 | 0.147 | 0.267 |
ANN8 | 0.554 | 0.177 | 0.269 | 0.518 | 0.22 | 0.262 |
ANN9 | 0.530 | 0.170 | 0.300 | 0.614 | 0.174 | 0.212 |
ANN10 | 0.567 | 0.122 | 0.310 | 0.583 | 0.284 | 0.133 |
Average relative importance | 0.531 | 0.178 | 0.292 | 0.576 | 0.203 | 0.211 |
Normalized importance (%) | 100.0 | 33.5 | 54.9 | 100.0 | 35.2 | 36.6 |
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Lee, A.H.I.; Kang, H.-Y.; Liu, Y.-A. A Pilot Study on the Satisfaction of Long-Term Care Services in Taiwan. Int. J. Environ. Res. Public Health 2022, 19, 90. https://doi.org/10.3390/ijerph19010090
Lee AHI, Kang H-Y, Liu Y-A. A Pilot Study on the Satisfaction of Long-Term Care Services in Taiwan. International Journal of Environmental Research and Public Health. 2022; 19(1):90. https://doi.org/10.3390/ijerph19010090
Chicago/Turabian StyleLee, Amy H. I., He-Yau Kang, and Yu-Ai Liu. 2022. "A Pilot Study on the Satisfaction of Long-Term Care Services in Taiwan" International Journal of Environmental Research and Public Health 19, no. 1: 90. https://doi.org/10.3390/ijerph19010090