A quality function deployment–based resource allocation approach for elderly care service: Perspective of government procurement of public service

Abstract

In response to the rapidly growing demand for elderly care service in China, rational allocation of limited resources and improvement of public satisfaction have become one of the urgent problems to be solved in government procurement of elderly care services. With the aid of quality function deployment, a programming model is established to allocate resource with maximizing customer satisfaction. Taking home care service as an example, on the basis of identifying the elderly’s requirements, designing attributes, optimal allocation of limited resource is conducted based on the proposed approach. Results show that staff in the home care service center should pay more attention to improve their service attitude and service quality. Meanwhile, more resources should also be allocated to improve the specialization of the franchise center, and to increase the provision of professional medical personnel and purchase of common medicines for emergencies as well as facilities for rehabilitation. This study expands the field of elderly care service by introducing a more efficient resource-allocation approach, thus helping governments in decision-making.

Keywords

Customer satisfaction elderly care service quality function deployment resource allocation

Background

China has made remarkable achievements in social progress and economic development since its reform and opening up in 1978. However, rapid economic development has also brought many social problems. With the main purpose of improving social welfare and constructing a harmonious society, social work has become an important and useful way to resolve social problems and construct a harmonious society in China. Both developed and developing countries all around the world are facing the challenges caused by an aging population (Siciliani, 2013). With the arrival of an aging society, China has made great achievements in the development of the aging industry. However, development is still lagging behind the speed of aging. From 2010 to 2014, the proportion of the population that is 65 years or older is expected to be more than double, from 9.0 to 22.6 percent (Xiang and Zhuang, 2016). As a result, the problem of elderly care service has become increasingly prominent. When China is entering the aging society rapidly, gross domestic product (GDP) per head was US$1000, which is far from the reality of the developed countries in Europe and the United States having entered the aging society era with a GDP of US$5000–US$10,000 per head. The actual situation in China of ‘aging before getting rich’ has brought great pressure to the government in providing sufficient elderly care services. According to the prediction of relevant departments, if one more bed for elderly care service is added, an extra 100,000 RMB will be invested by governments. Therefore, the mode of providing elderly care services merely by government alone is unable to meet growing needs of the elderly. Government procurement of elderly care services has become an inevitable choice in China, which conforms to the current situation of this country. In government procurement of elderly care services, the role of governments has been transmitted from service suppliers to coordinators and regulators, and supply of service has been delivered to a more professional organization through signing an agreement or in other specific ways (Guoxian and Hongqin, 2012). With the aging of society, demands for elderly care service surge, and resources for the elderly care are seriously lacking. Particularly, the lack of infrastructure, funds, and professional personnel is notable. It is reported that there is a gap of 31.54 million service beds in elderly care service institutions in 2017 in China, and the gap will even reach as large as 61.03 million by the year 2035. There is also a shortage of nursing staff. It is forecasted that there will be a gap of 1,043,550 employees in elderly care service institutions and 76,174 professional nursing staff in China by 2031 (Huang, 2013). Problems emerging due to an aging population become more and more serious, and resources for elderly care services cannot meet the requirements of the older people. Optimal allocation of limited social resources for elderly care is one of the important issues which must be addressed for current and future social work.

In view of the scarce elderly care service resources in China, scientific and rational division is made by many scholars and the strategy of resource integration is put forward (Wang, 2015). The approaches taken in some developed countries to deal with the problems in elderly care services also provide references for China. Taking the United Kingdom as an example, they take the mode of community care, which integrates all social resources, and provides full services for the elderly at home or in communities with formal and informal care networks. In Canada, institution care for the elderly is the main mode, while family care is also encouraged. The institutions can be divided into public, nonprofit, and profit ones on the basis of sponsors, and according to the caring needs of the elderly, they are divided into senior apartments, apartments with assistance, day care houses for the elderly and nursing homes. Resources are allocated based on different types of these institutions and various conditions of the elderly.

In all, government procurement of elderly care services transfers the provision of elderly care services to social organizations which are more professional. Market mechanism is introduced into elderly care services. Meanwhile, this market-based reform has also brought some unexpected social consequences, such as the eroding of social welfare of the elderly, uneven distribution of social resources, and so on. Therefore, social work, which aims at transferring social welfare to vulnerable groups and optimizing resource allocation, helps save social resources to the greatest extent and protect benefits for old people, who are vulnerable members of our society. The purpose of this article is to provide references for policy makers and service providers when they are designing the elderly care service, helping them make best use of limited resources and maximize satisfaction of the elderly. An approach to allocate the limited resources in elderly care services under government procurement is developed in this research: (1) requirements of the elderly are fully investigated and identified, including requirements in daily living care, medical care, spiritual consolation, and entertainment; (2) corresponding designing attributes are determined in view of the identified requirements, as well as the correlation between different requirements and designing attributes; and (3) with the aid of quality function deployment (QFD), a programming model is established to allocate resources in elderly care services on the basis of fully understanding customers’ requirements, while maximizing customer satisfaction at the same time.

The remainder of the article is organized as follows: a literature review, which serves as a basis for our proposed method, follows. The establishment of the model is then described in the Methodology section. Following this, our proposed model is applied in a practical scenario in China to verify the effectiveness and feasibility of the model. Finally, we present our conclusions.

Literature review

Public service for the elderly in China

With the aging of society, the Chinese government has made an effort to improve public service for the elderly. In China, the public service system for the elderly consists of material and immaterial supply guarantee (Chen and Man, 2013). In the past, public service for the elderly is rather limited in scope, content, and objects. With the development of living standards, requirements of the elderly increase. The main purpose of the public service supply for the elderly is to satisfy the increasing needs of the aged people. By now, a comparable sound framework of public service system for the elderly has been established in China. Various requirements of the elderly have been considered and satisfied to some extent. Li (2014) proposed a multi-public service supply system for the rural elderly including the joint of government leadership, marketing optimization, social collaboration, and elderly participation. Lei et al. (2015) investigated the floating elderly, and stated that the floating elderly should be included in the scope of public service, providing them with basic care services such as medical care, and so on. Feng et al. (2017) focused on the supply of sport public service for the elderly, and proposed that structural imbalances in the supply of sport public service for the elderly should be dissolved through transformation of supply mode and adjustment of supply structure.

There are plenty of studies on elderly care services, which are mainly about the practices, experiences, and current situation in different countries and areas, and so on. Mihic et al. (2016) focused on analyzing the investments into human resources aimed at enhancing home care for the elderly. Lei et al. (2015) provided insights into how it is possible to bridge the gap between policy intent and actual practice of care and service provision, and they elaborated on the concept of modularity, which could deal with the problem. Xu and Chow (2011) used China’s developments in elderly care services as a case study to document the progress of community-based service delivery for the elderly living in the community. Tynkkynen et al. (2012) explored the frames used by Finnish local authorities when they contract out elderly care services. They concluded that contracting with in the private sector is a means to improve the performance of public providers, as well as to improve service quality and efficiency. Wong et al. (2014) examined the recruitment challenges facing Hong Kong’s elderly care service providers and their results resonated with an earlier qualitative study. Winsløw and Borg (2008) studied the association between resources in the workplace and quality of elderly care services in municipal long-term care. In view of the service utilization and healthcare costs of the advanced elderly, Heinrich et al. (2008) conducted a bottom-up costing study to reach a conclusion that advanced elderly used a wide range of health services. They also underestimated the true costs of society.

The government procurement system for public service in China

Government procurement of public service (GPPS) is a necessary practice to transform governmental functions and improve administrative efficiency in China. It is effective and efficient in increasing the supply of public services, as well as improving the quality. Promotion of GPPS in China is a major act to innovate public service supply mode and improve quality and efficiency of public services. It is also of great importance for government to streamline administration and delegate power.

As to government procurement of elderly care services in China, many scholars have done plenty of studies from different perspectives. Xiaoyi (2012) conducted a survey of the elderly care services that are procured by the Shanghai municipal government and analyzed the cooperation mode and operation characteristics between government and nongovernmental organizations. Jing (2014) investigated the current state of fund management in government procurement of elderly care services in Ji’nan, and on the basis of that, a series of fund management and control systems were put forward, which played a certain role in improving the efficiency of government funds. Hongqin (2012) narrowed the aged care services under the procurement of government to the level of home care for the elderly and constructed a performance evaluation framework of government procurement of aged care services through case studies. Bao (2011) constructed the quality evaluation model of the government procurement the aged care services based on the SERVQUAL model from the five dimensions of ‘reliability’, ‘tangible’, ‘humanization’, and ‘responsiveness’, and so on. Ni and Zhang (2015) found that supply–demand imbalance of aged care services is significantly related to the aged care service’s funds, the amounts of the aged care service institutions, and the professionals who engage in aged care services using a matrix scatter graph and regression analysis. Also, this study has certain guiding significance to solve the problem of imbalance between supply and demand in China’s aged care services.

On the whole, although there are many studies on elderly care service, as well as government procurement of elderly care services, and many fruitful achievements have been made, there are still some shortcomings and gaps to be covered.

On the one hand, from the perspective of research content, related studies mainly focus on fund management, performance evaluation, quality evaluation, cooperation mode, and so on. However, there are few studies on the imbalance between supply and demand, and resource allocation for elderly care services under government procurement. On the other hand, from the perspective of research methods, most studies are subjective and qualitative, and quantitative analysis based on the mathematical model construction is scarce. As a result, studies about resource management in the elderly care service under government procurement lack reliable theoretical analysis. Therefore, we tried to propose an approach aiming at making an objective and reasonable allocation of the limited resources in elderly care services with full consideration of customers’ requirements, improving the social welfare and social work.

Methodology

An overview of QFD

QFD is a method for product design or service improvement driven by customer demands. Its purpose is to clarify the key points of quality control at the early stage of designing. With the application of QFD, customer needs could be converted into designing attributes of products, thus improving customer satisfaction. The core of QFD is to focus on customers’ requirements from feasibility analysis at the beginning to product manufacturing or service supplying. It puts emphasis on converting customers’ requirements into specific information which can be understood and implemented by all personnel concerned with product development, thus ensuring the final product can best satisfy customers’ requirements. Since the core of QFD is to convert, the method used to realize conversion is House of Quality (HoQ), which is an intuitive matrix expression, a basic tool of QFD. A standard HoQ is shown as Figure 1. In order to convert, a framework of HoQ is built, providing corresponding information needed, and results can be obtained through analysis and evaluation.

Figure 1.

Basic model of HoQ.

QFD has been widely applied by many companies around the world as a designing technique. Moreover, QFD has also achieved additional significance from scholars, and many researchers have tried to improve the model and extent of its application area. Bolar et al. (2014) studied management of public infrastructure systems based on the QFD method; Lam and Lai (2015) proposed an evaluation model combining QFD and analytic network process (ANP) to explore the environmental sustainability; Dat et al. (2015) proposed an integrated fuzzy QFD to support the market segment selection and evaluation process; Deb and Myburgh (2017) provided a new multicriteria approach that is based on fuzzy QFD for choosing criteria in the supplier selection. On the whole, far away from the initial field of product design, QFD has now been widely applied into various areas. In this research, QFD will be improved and applied to resource allocation in elderly care services. With the aid of HoQ, a programming model, with the goal of maximizing the elderly’s overall satisfaction, is finally established to allocate limited resources to various designing attributes. The core of QFD, focusing on customers’ requirements, ensures that the allocation of resources in the elderly care service takes full consideration of the elderly’s demands and their satisfaction can be achieved to the greatest extent.

Construction of the QFD-based resource allocation model

Framework of the resource allocation approach

This article aims to optimally allocate resources for the elderly care service, hence making the best use of the limited resources. Under constraints of budget and limited resources, various resources are allocated to designing attributes, which are obtained based on customers’ (the old people) preferences, so that highest satisfaction of the elderly is achieved. The framework of the proposed approach is as follows:

Step 1. Obtain the calculating formulas for the planned and the actual achieved degree of attainment of designing attributes.

Step 2. Obtain the calculating formula for cost.

Step 3. Obtain the calculating formula for overall satisfaction of the elderly on the basis of steps 1 and 2.

Descriptions of designing attributes

This research aims to extend the quality deployment plan from tactical level to operational level, considering the optimal allocation of various resources to different designing attributes, thus achieving the goal of maximal customer satisfaction. Assuming a scenario of an elderly care service supply under government procurement, $m$ customer requirements and $n$ designing attributes were identified from survey and investigation, which are denoted by $C R_{i}$ , $i = 1, 2, \dots, m$ and $j = 1, 2, \dots, n$ , respectively. The weight of each customer requirement is $d_{i}$ ( $i = 1, 2, \dots, m$ ), indicating the relative importance of $C R_{i}$ to overall satisfaction. The weight of each designing attribute is $w_{j}$ ( $j = 1, 2, \dots, n$ ), which can be expressed by the correlation matrix of the customer needs and designing attributes. The element $R_{i j}$ in the relational matrix R represents the degree of the influence of $D A_{j}$ on $C R_{i}$ . The value of the normalization for $R_{i j}$ is $R_{i j}^{*}$ whose range is $0 <_R_{i j}^{*} <_1 .$ $R_{i j}^{*}$ indicates the contribution $D A_{j}$ makes to the satisfaction level of $C R_{i}$ when $D A_{j}$ is fully satisfied. Then, we can get $w_{j}$ as shown in equation (1):

w_{j} = \sum_{i = 1}^{m} d_{i} R_{i j}^{*}, j = 1, 2, \dots, n

(1)

T is the correlation matrix of designing attributes and T_ij is a correlation factor representing the degree of correlation between designing attributes $D A_{i}$ and $D A_{j} .$ T_ij essentially reflects the contribution that $D A_{i}$ makes to $D A_{j}$ , when $D A_{i}$ is improved. The normalized T_ij can be explained as the amount of change in $D A_{j}$ when $D A_{i}$ is improved by one unit. x_j is applied to express the actual achieved degree of $D A_{j}$ . It is the ratio of the actual achieved value of the designing attribute to the value of the goal; for example, it can be 0.5. Because of the complex correlation between designing attributes, the linear expression $x_{j} = f_{j} (x_{1}, x_{2}, \dots, x_{n}),$ which is usually used to indicate the relationship between x_j and $x_{i}$ ( $i = 1, 2, \dots, j - 1, j - 2, \dots, n$ ), is not able to properly describe the complex relationship among designing attributes. Therefore, in our research, with the aid of the correlation factor T_ij between designing attributes, and the planned degree of attainment of target is introduced to describe the correlation of designing attributes. The actual achieved degree of target is the actual achieved value of the designing attribute, while the planned degree of attainment of target is the target value, which is usually determined by designers based on resource control. Let y_j be the planned degree of attainment of target for $D_{j} .$ Then corresponding x_j can be expressed as

x_{j} = y_{j} + \sum_{k \neq j} T_{k j} y_{k} = \sum_{k = 1}^{n} T_{k j} y_{k}

(2)

Equation (2) means that the actual achieved degree of attainment of the target for $D_{j}$ is the planned degree of attainment of target adding the contribution that other designing attributes make to $D_{j} .$ In addition, y_j satisfies the following constraints:

0 \leq y_{j} + \sum_{k \neq j} T_{k j} y_{k} \leq 1, j = 1, 2, \dots, n

(3)

Descriptions of resources and costs

It is assumed that there are $R$ kinds of resources involved in the elderly care service under government procurement, which would influence service quality, as well as customers’ satisfaction. Some of these resources impact one designing attribute and some impact multiple designing attributes. Furthermore, it is assumed that the impact of different resources on the corresponding designing attributes is independent and the effects are not related to each other. Therefore, the degree of the attainment of one designing attribute can be obtained by ordinary addition of the impact degree of each resource on this designing attribute. In practice, the impact of the resource on the designing attribute can be quantified by 4–2–1, which indicates strong–middle–weak. Let $E_{k i}$ $(k = 1, 2, \dots, L; i = 1, 2, \dots, n)$ be the quantified impact value after the normalization. $E_{k i}$ implies the contribution which the unit resource k makes to the designing attribute i( $D A_{i}$ ). Let $r_{k i}$ $(k = 1, 2, \dots, L; i = 1, 2, \dots, n)$ be the amount of the kth resource used to enhance $D A_{i} .$ Since the designing attribute’s the actual achieved degree of attainment of the target is obtained by the planned degree of attainment of the designing attribute determined relying on resources allocated, as well as by the contribution coming from correlation between designing attributes. Therefore, $x_{i}$ can be expressed as

x_{i} = y_{i} + \sum_{j \neq i}^{n} T_{j i} y_{j} = \sum_{j = 1}^{n} \sum_{k = 1}^{L} T_{j i} r_{k j} E_{k j}

(4)

In the elderly care service, the total amount of resources is limited. Let $R_{k}$ be the total amount of resources, then

r_{k} = \sum_{i = 1}^{n} r_{k i} \leq R_{k}, k = 1, 2, \dots, L

(5)

$p_{k}$ is the cost of the unit resource $k$ . So, the planned designing cost allocated to $D A_{i}$ is

c_{i} (y_{i}) = \sum_{k = 1}^{L} p_{k} r_{k i}

(6)

The sum of the planned designing costs allocated to all designing attributes is the total designing costs that are used for the elderly care service under government procurement cannot exceed the total budget $B$

0 \leq \sum_{i = 1}^{n} \sum_{k = 1}^{L} p_{k} r_{k i} \leq B

(7)

Overall satisfaction of customers

The overall satisfaction of customers is the weighted sum of satisfaction level of each customer $s_{i}$ $(i = 1, 2, \dots, m)$ . And $s_{i}$ , which means the satisfaction level of the ith customer, can be expressed by $x_{j}$ and the correlation matrix $R$

s_{i} = \sum_{j = 1}^{n} R_{i j}^{*} x_{j}, i = 1, 2, \dots, m

(8)

Therefore, the overall satisfaction level of customers can be expressed as

S = \sum_{i = 1}^{n} w_{i}^{*} y_{i} = \sum_{k = 1}^{L} \sum_{i = 1}^{n} w_{i}^{*} E_{k i} r_{k i}

(9)

where $y_{i}$ is the planned degree of attainment of $D A_{i}$ determined relying on resource allocation. And $w_{i}^{*}$ represents the contribution which the unit level of the planned degree of attainment of $D A_{i}$ produced owing to the autocorrelation makes to the satisfaction level. And $w_{i}^{*}$ is expressed as

w_{i}^{*} = \sum_{j = 1}^{n} w_{j} T_{i j}, i = 1, 2, \dots, n

(10)

The proposed resource allocation model

The model allocates the resources optimally to each designing attribute, and the satisfaction of customers is maximized. The proposed model can be described as the QFD-based resource allocation model, which is described as follows:

M a x S = \sum_{i = 1}^{n} w_{i}^{*} y_{i} = \sum_{i = 1}^{n} \sum_{k = 1}^{L} w_{i}^{*} E_{k i} r_{k i}

(11)

The constraints are shown in equations (12) to (16):

α_{i} \leq \sum_{k = 1}^{L} \sum_{j = 1}^{n} E_{k j} T_{j i} r_{k j} \leq 1, i = 1, 2, \dots, n

(12)

\sum_{k = 1}^{L} E_{k i} r_{k i} \leq 1, i = 1, 2, \dots, n

(13)

0 \leq \sum_{i = 1}^{n} \sum_{k = 1}^{L} p_{k} r_{k i} \leq B

(14)

\sum_{i = 1}^{n} r_{k i} \leq R_{k}, k = 1, 2, \dots, L

(15)

r_{k i} \geq 0, k = 1, 2, \dots, L; i = 1, 2, \dots, n

(16)

Among the above constraints, $α_{i}$ is the actual achievable value of $D A_{i}$ , which is determined by the designers.

Case study: The resource allocation of home care service center

The proposed QFD-based resource allocation approach is applied to the home care service, aiming to meet the requirements of the elderly in the home care service center and achieve the highest satisfaction of the elderly through reasonably allocating limited resources to various designing attributes. The process is as follows:

Requirements of the elderly and corresponding designing attributes are determined through questionnaire and field interview.

As the realization of designing attributes is closely related to resources, the categories and corresponding costs for designing attributes must be determined beforehand, as well as determining the correlation between designing attributes and resources. All of these will serve as the basis to solve the model.

Determine the correlation between customers’ requirements and designing attributes, based on which HoQ is built.

On the basis of the above steps, the proposed QFD-based model is applied to obtain the results of resource allocation while maximizing customers’ satisfaction in the home care service center.

Overview of home care service

Home care services for the elderly were mainly provided by nongovernmental organizations and family members, which is a typical pension service purchased by governments. With the development of an aging society and change of family structure in China, demands for home care services for the elderly increase substantially. More and more support has been provided to home care services by governments and all sectors of society. However, it is an embarrassing reality that imbalance between demand and supply and low efficiency in utilization of resources are problems to be addressed. Therefore, the resource allocation model proposed in this article is applied to home care services for the elderly to improve resource utilization efficiency and satisfaction for the older people.

Verulava et al. (2016) conducted a survey to study home care services rendered by nongovernmental organizations and family members in Georgia. They found that home care services for elderly people are mainly provided by nongovernmental organizations. The elderly are more dependent on the assistance provided by their relatives and they give priority to the services rendered at home, rather than to institutional care (in special clinics or retirement homes).

Although different countries have different healthcare social protection policies, when it comes to providing home care for the elderly, most countries have explicitly formulated plans that envisage a growth in this area and the substitution of residential and hospital care. For instance, in Germany, benefits are intended to cover only essential needs, and everything that exceeds that has to be covered by clients (Genet et al., 2012). Home care for the elderly in China is mainly driven by GPPS, relying on the community service resources and the active participation of volunteers. It provides the ‘day care plus door-to-door’ services and the ‘paid plus free’ services. Different areas in China have formed different modes of home care services. The usual mode is that the government subsidizes a fixed amount of money and facilities for the home care service center, instead of being responsible for the specific work. As the direct person in charge, the home care service center takes advantage of government support to provide home services or day care services for the elderly. In addition, the government could arrange the medical staff from the medical service station in the county town to provide free and on-site medical assistance for the elderly who are sick in bed, or hold the regular lecture about health care in the home care center free of charge. And for some of the paid home services, the government can cooperate with some franchise center that works as a mediator. A certain amount of service fee for each elderly man is paid to the franchise center and various door-to-door services are provided for the elderly by the center. Or according to the voucher system, the government issues coupons to the elderly who meet certain requirements, and the elderly who hold the coupons can enjoy the free services based on their needs.

Data collection

The communities of Nantong, Zhenjiang, Suzhou, and other cities in Jiangsu province were selected to conduct our case study. The survey was conducted from July 2018 to September 2018. Information and data were obtained through questionnaires and deep interviews. Demands of the elderly and corresponding designing attributes were fully investigated and identified. According to the established model, in order to obtain a corresponding amount of resources distributed to different designing attributes, we had to first get the quantitative relationship between demands of the elderly and designing attributes, resources and designing attributes, as well as autocorrelation between different designing attributes. So, first, the elderly were classified into two categories: those cared for by the community and those cared for in the community. Typical sampling is adopted here to issue questionnaires. In this round of surveys, 300 questionnaires were sent out, 285 of which were valid with a recovery rate of 95 percent. Demands of the elderly were then identified based on analysis of these questionnaires. Open questions were combined with leading questions to collect information about requirements of the elderly, such as ‘In life, which services do you expect the staff of the home care service center to provide for you? [multiple selection] – ○home cleaning and cooking services, etc. ○pay utilities ○accompany to see the doctor ○chat with and accompany ○else’; ‘In terms of health care, which services do you expect to enjoy in the home care service center? [multiple selection] – ○regular physical examination ○lectures on disease prevention ○emergency disease succor ○else’. Designing attributes were then identified to satisfy these demands. After that, questionnaires for further surveys were designed and delivered to the elderly, staff in the home care service center, and experts, to collect quantitative relationships between demands and designing attributes, in which 400 questionnaires were issued and the recovery rate was 92.8 percent. Relevant relationships between requirements and design attributes of the elderly were collected through the Richter scale. For example, ‘In your opinion, which of the following items is in line with the relationship between the workers in the home care service center (RE1) and service attitude and service quality of the employees in the home care service center (DA1)? – ○strong ○middle ○weak’. The autocorrelation of design attributes was also collected in the same way. Then, through interviews with employees in home care service centers, we got corresponding resources for different designing attributes, based on which, a questionnaire was designed to collect further quantitative correlation between resources and designing attributes, which was designed by Richter scale. In this round of questionnaire issuance, the elderly, employees in home care service centers and experts were surveyed, with 400 questionnaires sent out and 374 completed.

Identification of customer requirements

Requirements of daily living care $(C R_{1})$ . According to Maslow’s hierarchy of needs, the most urgent needs of the elderly are usually more basic. The elderly or the empty nest elderly who are inconvenient have a strong demand for some basic activities, such as bathing, haircut, escorting, and paying for water and electricity.

Requirements of medical care $(C R_{2})$ . Many old men of advanced age suffer from some common diseases, such as hypertension or osteoporosis. With the strengthening consciousness of health care, many elderly men increase the demand for prevention and rehabilitation.

Requirements of spiritual consolation $(C R_{3})$ . In the past, providing for the aged has meant providing them with materials such as the necessities of life, without considering their spiritual needs. With the progress of human civilization and the change of ideas, the elderly are more eager to be accompanied by their children than just receiving financial aid.

Requirements of entertainment $(C R_{4})$ . Through the investigation, not only the older people, widowed, or disabled elderly will seek help from the home care center, but also some elderly retired workers. The retired older men usually utilize the facilities such as the chess room, the drama room, and so on in the home care center to meet the needs of entertainment.

Determination of designing attributes

In the HoQ, designing attributes is the means applied to satisfy the requirements of customers, and the status of designing attributes influences customers’ satisfaction directly. Therefore, designing attributes are determined successively according to the requirements of the elderly.

Customer requirements in the home care service center and the corresponding designing attributes are shown in Table 1.

Table 1.

Customer requirements and designing attributes.

Customer requirements	Designing attributes
Daily living care $(C R_{1})$	Service attitude and service quality of the employees in the home care service center $(D A_{1})$
	The specialization of the league center chosen by the government $(D A_{2})$
	The structure and quantity of volunteers $(D A_{3})$
	The speed of response to the individual needs of the elderly $(D A_{4})$
Medical care $(C R_{2})$	Staffing of the medical professionals $(D A_{5})$
	Knowledge of first aid of the workers in the home care service center and the volunteers $(D A_{6})$
	Equipment of common emergency drugs and facilities for rehabilitative treatment in the home care service center $(D A_{7})$
Spiritual consolation $(C R_{3})$	Service attitude and service quality of the employees in the home care service center $(D A_{1})$
Spiritual consolation $(C R_{3})$	The structure and quantity of volunteers $(D A_{3})$
Entertainment $(C R_{4})$	The comfortable and safe environment in the home care service center $(D A_{8})$
Entertainment $(C R_{4})$	Equipment of interest class in the home care service center $(D A_{9})$

Resources and capital

To satisfy requirements of the elderly in daily living care, medical care, spiritual consolation, and entertainment, nine designing attributes are concluded in this article. Designing attributes are the means to meet the needs of the elderly and the realization of designing attributes is interlinked with resources closely. Relative resources can be divided into two categories: human resources and material resources, based on the above designing attributes. Specific resources and corresponding designing attributes are shown in Table 2, and Table 3 shows the correlation between resources and designing attributes.

Table 2.

Resource classification based on designing attributes.

One-level resources	Two-level resources	Designing attributes
Human resources	Workers in the home care service center (RE1)	$D A_{1}$ , $D A_{4}$ , $D A_{6}$
	Professionals in the league centers (RE2)	$D A_{2}$ , $D A_{4}$
	Medical staff (RE3)	$D A_{4}$ , $D A_{5}$
	Volunteers (RE4)	$D A_{3}$ , $D A_{4}$ , $D A_{6}$
Material resources	Medical resources (RE5)	$D A_{7}$
Material resources	Infrastructure resources (RE6)	$D A_{8}$ , $D A_{9}$

Table 3.

Correlation between resources and designing attributes.

	$D A_{1}$	$D A_{2}$	$D A_{3}$	$D A_{4}$	$D A_{5}$	$D A_{6}$	$D A_{7}$	$D A_{8}$	$D A_{9}$
RE1	•			◎		•
RE2		•		◎
RE3				◎	•
RE4			•	◎		•
RE5							•
RE6								•	•

◎: middle; •: strong.

In this case study, unit price and quantity of related resources of the home care service center are determined according to one home care center in Nantong, and are shown in Table 4.

Table 4.

Unit price of resources.

Resources	Notes	Average unit price (RMB) $p_{k}$
Employee in the home care service center (RE1)	Logistical personnel, accounting personnel, managers	2500 (yuan/month)
Professionals in the franchise centers (RE2)	Mainly conducting domestic service	2500 (yuan/ month)
Medical staff (RE3)	Doctors in cooperative hospitals	2000 (yuan/ month)
Volunteers (RE4)	From the government, companies, and schools	0 (yuan/ month)
Medical resources (RE5)	All kinds of medical equipment and medicines	1500 (yuan/ month)
Infrastructure resources (RE6)	Air conditioning, tables and chairs, tables for table tennis, and so on, upfront costs, which could be converted to cost per month	1250 (yuan/month)

Governments procured these resources to realize the public good properties of the home care service through capital subsidy. According to the unit price of these resources, the total amount of each resource $R_{k}$ is determined as follows: $p_{1}$ is 2500 and $R_{1}$ is identified as 5 basic units; $p_{2}$ is 2500 and $R_{2}$ is identified as 10 basic units; $p_{3}$ is 2000 and $R_{3}$ is identified as 5 basic units; $p_{4}$ is 0 and $R_{4}$ is determined as 20 basic units; $p_{5}$ is 1500 and $R_{5}$ is assigned with 30 basic units; $p_{6}$ is 1250 and $R_{6}$ is identified as 10 basic units.

Construction of HoQ

Based on the above analysis, the model of HoQ is constructed as Table 5.

Table 5.

HoQ for resource allocation of home care service.

		$D A_{1}$	$D A_{2}$	$D A_{3}$	$D A_{4}$	$D A_{5}$	$D A_{6}$	$D A_{7}$	$D A_{8}$	$D A_{9}$
					•		•				$D A_{1}$
					•						$D A_{2}$
					•		◎				$D A_{3}$
		•	•	•		•		•			$D A_{4}$
					•						$D A_{5}$
		•		◎							$D A_{6}$
					•						$D A_{7}$
											$D A_{8}$
	d_i										$D A_{9}$
CR ₁	0.35	•	•	•	◎
CR ₂	0.35					•	◎	◎
CR ₃	0.2	•		•
CR ₄	0.1								•	•

HoQ: House of Quality; ◎: middle; •: strong.

The correlation between customer requirements and designing attributes, which is expressed by weak–middle–strong, needs to be quantified with 1–3–9, respectively, and then standardized. The autocorrelation of designing attributes is also quantified by 1–3–9 and standardized. The influence of resources on designing attributes is quantified by 4–2–1, meaning strong–middle–weak, respectively. On the basis of these preparations, the proposed QFD-based resource allocation approach is applied and the result of resource allocation is shown in Table 6.

Table 6.

The result of resource allocation.

Optimal allocation of resources to designing attributes
$r_{k i}$	$D A_{1}$	$D A_{2}$	$D A_{3}$	$D A_{4}$	$D A_{5}$	$D A_{6}$	$D A_{7}$	$D A_{8}$	$D A_{9}$	Total distribution
RE1	3.65	0	0	0.15	0	1.19	0	0	0	4.99
RE2	0	7.24	0	2.75	0	0	0	0	0	9.99
RE3	0	0	0	1.18	3.81	0	0	0	0	4.99
RE4	0	0	12.43	1.99	0	5.57	0	0	0	19.99
RE5	0	0	0	0	0	0	29.99	0	0	29.99
RE6	0	0	0	0	0	0	0	5.54	4.45	9.99

Analysis and discussion

The allocation of each kind of resources to designing attributes is shown in Table 6.

Allocation of RE1 (workers in the home care service). The value of five basic unit resources of RE1 allocated to DA1, DA4, and DA6 is 3.65, 0.15, and 1.19, respectively, which means that 3.65 basic units of RE1 are allocated to improving the service attitude and service quality of employees in the home care service centers, 0.15 basic unit of RE1 to increasing the response speed of the individual needs of the elderly, and 1.19 basic unit of RE1 to enhancing the knowledge base of the first aid of employees and volunteers.

Allocation of RE2 (professionals in the center). The value of 10 basic unit resources of RE2 allocated to DA2 and DA4 is 7.24 and 2.75, indicating that 7.24 and 2.75 basic units of RE2 are allocated to strengthening the specialization of the franchise center and increasing the response speed to the elderly needs, respectively.

Allocation of RE3 (medical staff). The value of five basic unit resources of RE3 allocated to DA4 and DA5 is 1.18 and 3.81, respectively, indicating the relative amount of RE3 allocated to improving response to the needs of the elderly and increasing the provision of professional medical personnel.

Allocation of RE1 (volunteers). The value of 20 basic unit resources of RE4 allocated to DA3, DA4, and DA6 is 12.43, 1.99, and 5.57, respectively, indicating the relative amount of RE4 allocated to optimizing the structure and quantity of volunteers, improving response speed to the needs of the elderly, and strengthening the basic first aid knowledge base of the staff and volunteers in the home care service center.

Allocation of RE5 (medical resources). The value of 30 basic unit resources of RE5 allocated to DA7 is 29.99, which means that RE5 is all for purchase of common medicine for emergencies and facilities for rehabilitation (DA7), such as blood pressure devices, thermometers, common over-the-counter drugs, and so on.

Allocation of RE6 (infrastructure resources). The value of 10 basic unit resources of RE6 allocated to DA8 and DA9 is 5.54 and 4.45, respectively, indicating the relative amount of RE6 allocated to improving the environment and offering more interesting classes in the home care service center.

Conclusion

In response to the rapidly growing demand for elderly care services in China, rational allocation of limited resources and the improvement of public satisfaction are among the urgent problems to be solved. To make full use of government financing and improve customers’ satisfaction, a QFD-based model for resource allocation is put forward in this article, making some practical significance to the development of the elderly care service. Results show that staff in the home care service should pay more attention to improving their service attitude and service quality. Meanwhile, more resources should also be allocated to improve the specialization of the franchise center, increase the provision of professional medical personnel and purchase of common medicines for emergencies and facilities for rehabilitation. This study expands the field of elderly care services by introducing a more efficient resource allocation approach, thus helping governments in decision-making.

The key observations from the case study are as follows: (1) customers’ requirements and corresponding designing attributes in home care services for the elderly are identified, as well as the relationships between them, and (2) relative resources are allocated through the application of our proposed QFD-based model for resource allocation, with full consideration of customers’ requirements and their satisfaction. The proposed model is applicable in practice for resource allocation in GPPS. Based on the contributions of this article, further research could focus on customers’ vague and fuzzy expectations about certain services and try to find decision-making models to solve the problem and make a more favorable allocation of resources, as well as ways to improve customers’ satisfaction.

Moreover, based on the results of this research and combined with the current situation in China, suggestions for resource allocation in the elderly care service under GPPS include the following.

First, integration of idle resources goes hand in hand with optimally allocating limited resources for the elderly care service, so as to improve public satisfaction. According to relative deployment of the State Council, a notice on supporting integration and transformation of idle social resources for the development of elderly care services was jointly issued by 11 ministries and commissions. In this notice, the elderly care service is to be developed and improved through integrating idle resources, so as to meet increasing demands in the elderly care service. In this research, a resource-allocation approach is provided to optimally allocate and make full use of the limited resources. To solve the problem of resource shortage in the elderly care service in China, it is critical to integrate idle resources and distribute them scientifically in order to make full use of them.

Second, bring forth new ideas in resource allocation in the elderly care service. The General Office of the Communist Party of China (CPC) Central Committee and the State Council have issued guidance innovating government’s allocation of resources, indicating that, in order to address current issues on the government’s resource allocation, such as market price distortion and so on, reform should be promoted both in breadth and depth. Direct allocation by governments should be decreased substantially, while market mechanisms and more market-based ways are introduced and encouraged to improve the efficiency and effectiveness in resource allocation. In government procurement of the elderly care service, market-oriented means meeting the needs of the elderly while improving efficiency of resource allocation. Therefore, fully considering customers’ requirements and maximizing customers’ satisfaction in the process of allocating resources is a claim by policy makers. What we are doing in our study is providing references for policy makers and service providers when they are designing the elderly care service, helping them to make best use of limited resources and maximize satisfaction of the elderly.

The work of this article is closely related to social work. The Decision of the Central Committee of China on Several Major Issues Concerning the Construction of a Socialist Harmonious Society, issued at the sixth session of the 16th CCCP, proposed to build a large social work personnel to promote the construction of a harmonious society in China. The Central Committee of China has pushed forward the development of social work in the form of political documents. During government procurement of the elderly care service in China, insufficient funding from government has caused resource shortage in this service. The welfare of the elderly and social equality have been seriously damaged. Based on international experiences, the development of social work is essential to solve such social issues. With the goal of maximizing old people’s satisfaction, this research realizes optimal allocation of limited resources in elderly care services. It is of great significance to social work, which focuses mainly on caring for vulnerable groups and constructing a harmonious society. This kind of social work with the purpose of optimizing resource allocation not only promotes social stability and development, but also strengthens social trusting of governments.

Footnotes

Acknowledgements

The authors express sincere appreciation to the anonymous referees for their helpful comments to improve the quality of this article.

Declaration of conflicting interests

The author(s) declared potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The author(s) received financial support for the research, authorship, and/or publication of this article: The work was supported by the Humanities and Social Science Foundation of Ministry of Education under Grant number 19YJA880068 and and Postgraduate Research & Practice Innovation Program of Jiangsu Province under Grant number KYCX18_2301.

ORCID iD

Lan Xu

Author biographies

Lan Xu (PhD) is an associate professor at the School of Economics and Management in Jiangsu University of Science and Technology, Zhenjiang, Jiangsu. She is now a visiting scholar in the University of Calgary, Calgary, Alberta, Canada.

Yuting Zhang is a postgraduate at School of Economics and Management in Jiangsu University of Science and Technology.

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