Grading Nursing Care Study in Integrated Medical and Nursing Care Institution Based on Two-Stage Gray Synthetic Clustering Model under Social Network Context

A machine learning-based hybrid recommender framework for smart medical systems

This article presents a hybrid recommender framework for smart medical systems by introducing two methods to improve service level evaluations and doctor recommendations for patients. The first method uses big data techniques and deep learning algorithms to develop a registration review system in medical institutions. This system outperforms conventional evaluation methods, thus achieving higher accuracy. The second method implements the term frequency and inverse document frequency (TF-IDF) algorithm to construct a model based on the patient's symptom vector space, incorporating score weighting, modified cosine similarity, and K-means clustering. Then, the alternating least squares (ALS) matrix decomposition and user collaborative filtering algorithm are applied to calculate patients' predicted scores for doctors and recommend top-performing doctors. Experimental results show significant improvements in metrics called precision and recall rates compared to conventional methods, making the proposed approach a practical solution for department triage and doctor recommendation in medical appointment platforms.

Middle-aged and older people's preference for medical-elderly care integrated institutions in China: a discrete choice experiment study

BACKGROUND

With the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years.

OBJECTIVES

To explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions.

METHODS

In this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants' willingness to pay for each attribute was also calculated.

RESULTS

Data from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: β = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: β = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for "poor service quality" and "low medical technology level," respectively, to receive "moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and "high medical technology level" (p = 0.005, 95% CI 852 ~ 4824).

CONCLUSIONS

The state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly.

PUBLIC CONTRIBUTION

The design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.

Community home elderly care services, multidimensional health and social participation of chronically ill elderly-Empirical analysis based on propensity score matching and multiple mediation analysis

Introduction

In recent years, China's aging process has deepened rapidly, the disease spectrum of the population has undergone major changes, the proportion and scale of elderly patients with chronic diseases are growing rapidly, and the multidimensional health problems of the chronically ill elderly are prominent, seriously affecting the participation of the chronically ill elderly in family, community, and social development. In response, China has implemented the "active response to population aging strategy," accelerated the development of community home elderly care services, and encouraged the chronically ill elderly to continue to play a role through social participation. So how does the community-based home-based medical care service affect the social participation of the chronically ill elderly? Is an important subject.

Methods

Based on the 2018 China Longitudinal Aging Social Survey and the propensity score matching method to measure the impact of community home elderly care services on the four types of social participation of chronically ill elderly, including economic participation, family participation, voluntary participation, and political participation, and group differences, and uses the multiple mediation analysis method to explore the mechanism and effect of community home elderly care services on the four types of social participation of chronically ill elderly.

Results

(1) Community home elderly care services have an asymmetric impact on the social participation of the chronically ill elderly, and have generally promoted the level of social participation of the chronically ill elderly. (2) Community home elderly care services change the social participation arrangements of the chronically ill elderly by driving and inhibiting effects, so that it has a tendency to reduce economic participation and increase voluntary participation and political participation as a whole. This feature shows group differences among the chronically ill elderly of different ages, education levels, living arrangements and community types. (3) Community home elderly care services have an asymmetric impact on various social participation of the chronically ill elderly through the multidimensional health mediation mechanism.

Conclusion

(1) With the continuous deepening of the interweaving between the growth of chronic diseases and the aging of the population in China, the development of a positive aging society must attach great importance to the important role of social participation for the chronically ill elderly. (2) Strengthen the development of physical, psychological, and social adaptation and other health abilities of the chronically ill elderly, shape their awareness of social participation, and give the chronically ill elderly a reasonable social role orientation. (3) Through policy incentives, promote the realization of fairness, justice, adequacy, and sustainability of community home elderly care services. (4) Pay special attention to the penetration, integration, and application of digital technology into the field of community home elderly care services to effectively protect the health of chronically ill elderly, ensure that the elderly with different chronic diseases participate in social activities of high quality, enjoy a high-quality happy life, and promote the high-quality development of the aging society.