Prioritizing Long-Term Care Services for Disabled Older Adults: A Cross-Sectional Study Using the Kano Model and...

Area of Science:

• Gerontology
• Health Services Research
• Quality Management

Background:

• Understanding long-term care (LTC) needs is crucial for effective care systems.
• Current assessments lack actionable strategies for resource allocation in LTC.
• Nursing managers require evidence-based guidance for prioritizing LTC services.

Purpose of the Study:

• To determine the hierarchical structure of LTC service demands among disabled older adults using the Kano model.
• To establish an evidence-based supply priority order via integrated entropy-weighted TOPSIS analysis.
• To provide nursing managers with a quantifiable sequence for phased resource allocation.

Main Methods:

• A cross-sectional survey of 585 disabled older adults was conducted across Chengdu.
• Participants completed a Kano model questionnaire assessing 52 service items.
• Kano analysis classified services, and entropy-weighted TOPSIS determined supply priorities.

Main Results:

• Kano analysis categorized 52 items: 12 must-be, 14 one-dimensional, 10 attractive, and 16 indifferent.
• Vital signs monitoring and oral medication administration were top one-dimensional priorities.
• Cognitive training emerged as the highest priority attractive service; TCM nursing services were largely attractive or one-dimensional.

Conclusions:

• The Kano-TOPSIS framework effectively identifies LTC need hierarchies and supply priorities.
• A tiered approach prioritizing must-be, then one-dimensional, and finally attractive services is recommended.
• This user-centered strategy enables responsive LTC design and bridges the supply-demand gap for nursing managers.