Ensuring the Service Quality of Long-Term Care Provided through Competitive Markets: The Experience of Care Workers' Training in Japan

Ensuring the service quality of long-term care provided through competitive markets is a major concern among the governments of OECD members. The public officials in these nations recognise the importance of care workers' training to address this issue. However, most of them have hesitated to introduce comprehensive training due to financial constraints. Analysing the experience of Japan, this paper reveals that governments can ensure the financial sustainability of care workers' training by aiming at the best possible long-term care.

Managing the Human Service Market: The Case of Long-Term Care in Japan

Providing human service through competitive markets is inherently problematic. On one hand, quality care is critical; unsatisfactory human service greatly influences people’s quality of life. On the other hand, profit for human service providers is essential for sustainable service provision. This thesis focuses on striking a balance between human services’ need for quality assurance and market providers’ need for profit. The research primarily examines the provision of long-term care for the elderly in Japan, which has the biggest share of aged population among the OECD members. Two research questions guide the empirical research: 1. How should governments design the human service market in order to keep the capacity to ensure the quality of service? 2. How should governments set the performance measurement for quality care? The research presents and tests two models. The first model addresses market competition practices and offers an alternative care quality model, called Ideal CQM. Ideal CQM seeks to overcome deficiencies in the existing care quality model, which allows the market to accommodate poor quality care. To this end, Ideal CQM presents a theoretical market design in which quality of care is the sole basis for market competition. By implementing Idea CQM, governments can direct the market competition to enhance the quality of care and poor quality service can be automatically eliminated from the market. The second model addresses performance measurement and is a process-based model, which values the experiences of front-line care workers. The process-based performance measurement seeks to overcome deficiencies in the existing outcome-based performance measurement, which is rendered ineffectual by two unique features of human service: ambiguous policy goals and a considerable amount of front-line worker discretion. This thesis, thus, modifies the existing concept of market competition utilising public administration theory to accommodate the process-based performance measurement model. The research supports the use of market competition to provide human service for long-term care. Approving the workability and the practicability of the presented two models, the thesis concludes that governments can achieve balance between quality assurance and sustainable provision, if they are willing to meet the required conditions for implementation of the two models

Are Chinese Workers from the One-child-policy Generation Selfish in a Group? Evidence from Worker Surveys in Six Major Chinese Cities

Many claim that Chinese people born after the one-child policy of 1979 are very individualistic or even selfish. This research tested the hypothesis that Chinese workers of the one-child-policy generation have difficulty working in a team, addressing the absence of nation-wide evidence. Using workers’ surveys, for the first time, across six major Chinese cities, the results denied the hypothesis, at least in the workplace

Willing or hesitant? A socioeconomic study on the potential acceptance of COVID-19 vaccine in Japan

The worldwide COVID-19 vaccination program is already underway, raising hopes and aspirations to contain the spread of the COVID-19 pandemic that halted economic and social activities. However, the issue of vaccine effectiveness and its side-effects is influencing the potential acceptance of vaccines. In this uncertain situation, we used data from a nationwide survey in Japan during February 2021, following the Japanese government’s initial phase of COVID-19 vaccination. Our results show that 47% of the respondents are willing to take a vaccine once it is available, while 22% are not willing and another 31% remain indecisive. Our ordered probit regression results show that demographic, socioeconomic, and behavioral variables such as gender, age, subjective health status, children, household income, household assets, financial literacy, future anxiety, and myopic view of the future are associated with willingness to take a COVID-19 vaccine. Our findings suggest that Japan’s government should not adopt a one-size-fits-all policy to promote the vaccination program, but rather target people with specific socioeconomic backgrounds who are less willing and more hesitant to take a vaccine