China, People's Republic of: Improving Capacity for Home-Based Hospice Care of the Elderly in Beijing
The knowledge and support TA will support the Beijing Municipal Health Commission (BHMC) in the People's Republic of China to improve access, capacity, standards, and service coordination of the home-based geriatric hospice care system and services. It will help BMHC develop policy recommendations, home-based hospice care needs assessment and guidelines, and admission and referral criteria for home-based hospice care for elderly.
East Asia Department
Request for information
China, People's Republic of
|Project Name||Improving Capacity for Home-Based Hospice Care of the Elderly in Beijing|
|Country / Economy||China, People's Republic of
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
|Sector / Subsector||
Health / Health system development
|Gender Equity and Mainstreaming||Effective gender mainstreaming|
|Description||The knowledge and support TA will support the Beijing Municipal Health Commission (BHMC) in the People's Republic of China to improve access, capacity, standards, and service coordination of the home-based geriatric hospice care system and services. It will help BMHC develop policy recommendations, home-based hospice care needs assessment and guidelines, and admission and referral criteria for home-based hospice care for elderly.|
|Project Rationale and Linkage to Country/Regional Strategy||
Palliative care is an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment, and treatment of pain and other problems, whether physical, psychosocial, or spiritual. Hospice is a type of palliative care for people at the final stages of life. Each year, an estimated 40 million people need palliative care worldwide and only 14% of them currently receive it. Adequate national policies and programs that are designed to ensure gender equality and social inclusive approach, resources, and training on palliative care among health professionals are urgently needed to improve access. The global need for palliative care will continue to grow because of the aging of populations and the rising burden of diseases._In 2000, the PRC formally became an aging society, when its population aged 65 and above exceeded 7% of the total._In 2019, this ratio reached 14% (254 million) and is expected to reach 28% (402 million) in 2040.
The Government of the PRC has been responding to these challenges by developing national policies and programs and investing in services and systems that support rapid adoption and development of hospice care. In 2017, the National Health Commission issued the Notice on Pilot of Hospice Care, which officially launched piloting of hospice care in the PRC; and in 2019, it issued the Notice on the Second Batch of Pilot of Hospice Care and the Notice on Enhancing Geriatric Home-Based Medical Services._In 2017, BMHC launched the first pilot of 15 hospice care entities and established basic standards and service specifications for the pilot entities, which indicated the development of hospice care in institutions in Beijing. Following the issuance of the national hospice care policies, Beijing, as the center of the leading government, research and academic institutions, is ideally positioned to develop, promote and set examples for replication in other parts of PRC for quality hospice care standards and services that are inclusive and applicable in varying home-based care context by (i) developing and piloting the home-based hospice care service system and home-based hospice care referral criteria and practice guidelines; (ii) improving the service providers' capacity;_and (iii) developing and piloting the training system, which could play as an exemplary and leading role in PRC in helping improve the_end of life care of the elderly in the country. The results of the research and pilots will be_shared and implemented in healthcare institutions throughout the entire country. In 2019, BMHC conducted surveys on hospice care status and needs, admission standards and specifications, and list of services for hospice care at the community level. In 2020, BMHC issued the Notice on the Determination of Hospice Care Guidance Center and the First Batch of Hospice Care Demonstration Bases in Beijing. In 2021, BMHC started developing the model and mechanisms combining institutional, community, and home-based hospice care. BMHC also encouraged and guided community health service centers to pilot and provide community and home-based hospice care services. In 2022, BMHC issued the Implementation Solution for Accelerating the Development of Hospice Care Services in Beijing, which aimed to further improve quality and supply capacity of hospice care services in institutions.
To gradually meet the hospice care needs of the elderly in health institutions, BMHC issued relevant policies, enhanced the system, developed an inpatient hospice care model, and improved human resources capacity. In contrast, home-based hospice care for older people is still at the early stages of development. In line with the current geriatric care pattern in Beijing, about 90% of the elderly are expected to receive home-based elderly care, which reflects the substantial demand for home-based hospice care. Considering the substantial demand for home-based hospice care, the government has been paying attention to the complexity of home-based services, which creates a challenge for the development of respective guidelines and the variability of geriatric health status that highlights the need for developing patient referral criteria. These factors present unprecedented challenges to the PRC hospice care service capacity as the healthcare staff from other medical-related specialties needs to be trained for the provision of the hospice care. Therefore, the development of the patient referral criteria, geriatric home-based hospice care guidelines, and training programs and courses is critical to promoting the home-based hospice care.
The hospice education and training programs need to be improved by (i) developing early screening criteria, checklists and referral procedures, care needs assessment, and comprehensive education and training programs for palliative and hospice care tailored to gender-specific needs and behaviors; (ii) identifying prognostic factors of timely palliative care referral; and (iii) developing evidence-based and tailored palliative care and hospice services._The capacity of medical personnel to provide home-based hospice care is the most critical factor to improve quality of life of the elderly during their end-of-life phase. In addition, due to the lack of systematic hospice care training, both nursing theory and practical skills of medical personnel are insufficient to meet the demand of the elderly and their families for hospice and palliative care.
The TA will build on experiences and lessons learned from elderly care projects and hospice care pilots funded by ADB in the PRC that highlight the importance of focusing on community and home-based elderly care services; improving coordination and cooperation of agencies in charge of the elderly care policies, systems, and services; promoting close cooperation between the social and healthcare institutions; and investing in developing human resources capacity and knowledge._The TA is closely aligned with strategic priority 3 of the ADB country partnership strategy for the PRC, 20212025, which aims to strengthen the PRC's health systems and address key challenges in adapting to an aging society.
Access to home-based geriatric hospice care improved (Guidelines on Deepening Reforms of Medical Security System)
Management of gender-responsive and socially inclusive home-based geriatric hospice care system strengthened
Standards, guidelines and referral criteria for home-based geriatric hospice care developed
Healthcare staff capacity and inclusive home-based geriatric hospice care strengthened
|Summary of Environmental and Social Aspects|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design|
|During Project Implementation|
|Consulting Services||ADB will engage (i) a consulting firm with expertise in hospice care using the simplified consultant's qualifications selection method and simplified technical proposal; and (ii) an individual hospice care consultant using individual consultant selection method. Engagement of consultants will follow the ADB Procurement Policy (2017, as amended from time to time), ADB Procurement Regulations (2017, as amended from time to time) and its associated Procurement Guidance Notes and Procurement Staff Instructions._The national consulting firm will have 54 person-months of total inputs and will be recruited using simplified consultants' qualifications selection method.|
|Procurement||Procurement will follow ADB Procurement Policy (2017, as amended from time to time), ADB Procurement Regulations (2017, as amended from time to time) and its associated Procurement Guidance Notes and Procurement Staff Instructions.|
|Responsible ADB Officer||Mamatkulov, Raushanbek|
|Responsible ADB Department||East Asia Department|
|Responsible ADB Division||Urban and Social Sectors Division, EARD|
Beijing Municipal Health Commission
|Concept Clearance||26 Oct 2022|
|Fact Finding||11 Nov 2022 to 11 Nov 2022|
|Last Review Mission||-|
|Last PDS Update||02 Nov 2022|
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