Period: 10/1/21 - 9/30/24
Project leader: PhD Marija Bogataj
Financial resource: Public Agency for Research of the Republic of Slovenia (75%),
MEDIFAIS Fakulteta, Lunačkova 8, Mirna, 8233 (25%)
Code included in ARRS records: L7-3188 (C)
Sustainable Development Goal: 11 - Sustainable cities and communities
Scientific field of the project according to the Common European Research Classification Scheme: S215 - Social problems and welfare, national insurance
In accordance with the "Operational Programme for the implementation of the European Cohesion Policy for the period 2014–2020", Slovenia identified the promotion of the availability of affordable, sustainable, and high-quality health and social services for old and very old inhabitants, as a key area, but housing and logistics for these inhabitants is not considered. The key issue that has not been answered till now is how to develop a quantitative model for supporting decisions (DSS) on rojection of these needs, development, and operation the long-term care (LTC) and how to plan and provide appropriate housing, logistics and other facilities for the needs of seniors, which will be available in accordance with the demand. As stated in the Operational Programme, Slovenia does not have a compact system for the regulation of LTC. Given the demographic structure and projections, there is a need for a reform that will allow the establishment of a uniform system of community-based services for the elderly as well as for those who will need institutional forms of care. Slovenia is preparing new legislation in the field of LTC, which will need to take into consideration a different type of facility where LTC services will be provided. This will require the development of a model for the following purposes: projecting the needs and determining the eligibility criteria for receiving the benefits of integrated health and social services and LTC; monitoring the recipients of services as well as the funds for LTC. Therefore, In the research project, we shall develop a model for planning, operating and control the social infrastructure, logistics and other activities in the LTC in rural areas. Also, we shall propose the way of measuring the quality of the system of LTC since even the OECD documents state that such a model has not yet been developed. A more objective measuring instrument based on actuarial–mathematical methods will be included. Thus, the objective of the project is to present the ways of developing DSS model for the LTC system in rural areas, where the distances among clients require additional ICT and logistic solutions. The ways in which ambient assisted living (AAL) technologies support logistic activities and the flows in a hierarchical system of LTC using different types of sensors, computers, mobile devices, wireless networks, and software applications, will be studied.
The proposed project methodology will be based on two-phase modelling components: the qualitative and quantitative social research methods as well as secondary analysis and statistics. From these data the demographic projections and projections of seniors regarding their functional capacities, needs and demand will be presented. From these projections the adequate capacities of the social infrastructure, housing, logistics and required human resources will be projected; meanwhile, the second part will focus on the optimization of the integrated care services in municipalities and LAGs. Hierarchical DSS model will be developed combining vehicle routing problem with time windows calculated from the surveys (VRPTW) implemented in the system of integrated care and optimization of the hierarchical regional system of the social facilities on the bases of the INTRAMAX.
This will enable us to develop an appropriate DSS required for integrating different positions of service providers (focusing on social entrepreneurship), municipalities and the central government with respect to the responsibilities of financing LTC services in rural areas and supporting the development of social infrastructure.
Direct application of solutions will be multifaceted:
(a) we will support municipalities in planning social infrastructure and services in communities,
(b) show the opportunities that social entrepreneurship has in the set LTC systems and accompanying services,
(c) we will enrich modern and urgent professional and university study programs.
Relevance to the development of science or a scientific field
Until the last decade, a critical vision of the meaning and potential role of adequately constructed housing units and other social infrastructure for the older adults in home and community care networks has been remained largely absent from the scientific debate, while the structure of operating costs in the institutional care has been dealt with in-depth already in Madritsch et al. (2008). The authors presented the savings potential of LTC facilities at given social infrastructure (not trying to optimize it), revealing the immense potential of saving on the costs of various services. They discovered that professional property planning, management and control of the long-term care facilities would lower costs in the sector and expenditures of clients.In our study, we wish to expose the fact that planning of the home care infrastructure and services should include a comparison with investments in facilities and logistics. The care should be studied integrated, including health and social care as well as logistics and facilities management, which were not yet studied together This is especially important in the case of spatially dispersed clients in rural areas.
Older adults expect instrumental and emotional support from friends and neighbours as a means of informal care (Nguyen et al., 2016). Seniors wish to stay close to their social networks when they move from the previous home to institutional care. The older adults would like to stay at home if IADL would be better organised. We found that in case these services are not appropriate, seniors are ready to move in a concentrated community care, but wish to stay close to their home. How does it influence total LTC costs? It is not studied yet.
For planning the home-care routing and satisfying the housing needs on the lowest level of our hierarchical system, improved Patterson-Albracht algorithm, known in industrial engineering will be applied to the optimisation of services. This will be one of the first novelties in the hierarchical DSS, especially needed in rural areas, where the distances between clients can be significant.
The next is a combination of this optimization algorithm with the optimal regionalization method of the social facilities on the intermediate and the regional (NUTS-3) level, where the applicability of services in LAGs will be evaluated. Such a DSS model is also a novelty.
The special case of physiotherapeutic services will be integrated into the DSS.
At the beginning of Millenium, the global economic and research community first popularized "Industry 4.0" as a catch-all term to describe advances first to global economic and business models, but we are trying to introduce it also in hierarchically planned, managed and controlled social care systems , stemming from the CBS methodology We shall develop evaluation methods for new tools in the logistics and domotics.
Impact of the project for the economy
In the EU policy for rural development, the concept of smart villages emerged to address the need of EU 2020* strategy to be implemented, with the priorities as intelligent, sustainable, and inclusive development. It should be the answer to the search for the sustainable development of rural, especially shrinking villages in peripheral areas. The conceptualization and operationalization are formulated more as an analogy to the smart city, containing six basic dimensions: management, economy, mobility, natural and social environment, and quality of life. The goal was the cohesion and strengthening rural development, but the spatial planning and transportation issues were not considered enough. We wish to add these dimensions to the previous studies, where the older adults are in our focus. In our study of smart silver villages traditional and new networks and services will be considered in the hierarchical systems, to be strengthened by the means of digital technologies, telecommunications, innovation and better use of knowledge. Namely, in this context, Europe understands smart villages as more or less dispersed but well-connected rural communities that can take advantage of the technological developments and the benefits of rural "greening". Though the ageing of the European population is not in the focus of the Smart Villages yet, our approach will also fit the context of developing the Smart Villages and a European "silver" economy. Namely, the Silver Economy has caught the attention of scientists, policymakers, and economic operators alike. They agree that the ageing of wealthy European cohorts promises higher demand for products and services, more jobs and thus economic growth. How to support and evaluate the increase of jobs in a rural area, where the population is less wealthy, especially the increase of jobs in LTC including logistics for older adults and other services will be the subject of our research.
Direct application of solutions will be multifaceted:
Through population projections and categorization of care needs, we will support municipalities in planning social infrastructure and services in communities, which is the task of municipalities.
We will show the opportunities that social entrepreneurship has in the set LTC systems and accompanying services. Many young people in the field of social entrepreneurship could find their place for employment and development and therefore would not move to larger cities.
By supplementing the study programs of social gerontology, housing fund management and logistics for the elderly, we will enrich modern and urgent professional and university study programs, also by designing training program for the elderly to work for the ever-increasing jobs.
Impact of the project for society
In 2015, the General Assembly of UN adopted the 2030 Agenda for Sustainable Development that consists of 17 Goals (SDGs), in # Envision 2030*, exposing the principle of “leaving no one behind”, to achieving sustainable development for all. The majority of goals are followed in our proposal. The 17 SDGs are: (1) No Poverty; (2) Zero Hunger; (3) Good Health and Well-being; (4) Quality Education; (5) Gender Equality; (6) Clean Water and Sanitation; (7) Affordable and Clean Energy; (8) Decent Work and Economic Growth; (9) Industry, Innovation and Infrastructure; (10) Reduced Inequality; (11) Sustainable Cities and Communities and (17) Partnerships to achieve the Goal. The goals included in our proposal are underlined.
In many, including European countries and Slovenia, old people in rural areas, especially those who need a help of others due to reduced functional capacities, have much lower monthly incomes than other citizens. They have more difficult access to health and social care services due to the greater dispersion of housing in the wider area and the distance to these services. The children of these people emigrate to cities because they cannot find employment in rural areas, (the goal 8), and the elderly are left without adequate care. Therefore, innovations in the construction of appropriate infrastructure and especially logistics services, which would contribute to easier communication with central places are extremely important. As a rule, such networks are of a hierarchical nature and are linked to the hierarchical spatial arrangement of the state, where higher-level services are located in central places. Therefore, our intention is to determine how to optimally, given the investment and operating costs at the desired quality of care, organize networks for the care of the elderly in a hierarchical arrangement, and to find out what kind of jobs LTC systems can offer to younger cohorts and what is the appropriate logistics in the countryside in order to contribute to its revitalization.
These goals are also followed by the initiative "Smart villages ", which is leading our activities and this proposal**. "The Smart Village Initiative" was first put forward in the European Parliament in 2017, to "map out challenges and opportunities in rural areas, provide a definition of 'Smart Villages'. In this document, it is concluded that "the opportunity for smart villages comes from key drivers of change in the countryside, including the impact of existing and emerging digital technologies, new short supply chains, new patterns of mobility and better transportation and communication with cities".