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Systemic Design for Change in Community Care for Older Adults: the Shanghai Jing’an ‘Five-bed linkage’ Care Model

Format: Papers, RSD13, Topic: Health & Well-being

Jing Chen, Wen Lu, Min Hu, Qi Chen, Amina Pereno, Silvia Barbero and Long Liu

The Linfen Community is situated in the ‘shanty kingdom’ of Zhabei District, towards the northern part of Shanghai's city centre. In 2015, Zhabei District merged with the economically affluent Jing'an District to form the new Jing'an District. This district's demographic structure resembles an ‘inverted pyramid’, with a significant proportion, 41.5% of its population being older adults aged 60 and above. As one of the foremost areas in Shanghai to confront profound ageing challenges, the Linfen Community Health Service Centre is at the vanguard of fostering innovations in community nursing to address the healthcare accessibility delays prompted by an ageing population. This research aims to enhance the existing care model by integrating systemic design methodology. It aims to dismantle the ‘last kilometre’ barrier in older adult care, facilitate the transition from China’s innovative ‘Five-Bed Linkage’ service model to a sustainable care model, and forge a new service model while making recommendations for future advancements. By interpreting systemic design tools, it analyses the current state of integrated care services in China and globally. By employing qualitative interviews and utilising stakeholder maps, among other design tools, the study seeks to understand the current service mode thoroughly, identify challenges from a cross-cutting scale perspective, explore challenges, and engage various stakeholders in the co-creation of a new model via design workshops. The outcome of this research is developing a tailored approach for older adult individuals at varying stages of the disease, aiming to construct a more complete, efficient, and humanity-centred integrated healthcare and care service system. This system is envisioned as sustainable from different perspectives and information dissemination channels. This comprehensive approach promises to address current needs and adapt to future developments in healthcare provision for ageing populations.

KEYWORDS: community care, care model, five-bed linkage, older adults, systemic design

Citation (APA 7)
Chen, J., Lu, W., Hu, M., Chen, Q., Pereno, A., Barbero, S., & Liu, L. (2024). Systemic design for change in community care for older adults: the shanghai jing’an ‘five-bed linkage’ care model. Proceedings of Relating Systems Thinking and Design, RSD13. Article PAP-024. https://rsdsymposium.org/systemic-design-for-change-in-community-care-for-older-adults/

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Citation Data

Author(s): Jing Chen, Wen Lu, Min Hu, Qi Chen, Amina Pereno, Silvia Barbero and Long Liu
Year: 2024
Title: Systemic Design for Change in Community Care for Older Adults: the Shanghai Jing’an ‘Five-bed linkage’ Care Model
Published in: Proceedings of Relating Systems Thinking and Design
Volume: RSD13
Article No.: PAP-024
Post URL: https://rsdsymposium.org/systemic-design-for-change-in-community-care-for-older-adults
Host: Oslo School of Architecture and Design
Location: Oslo, Norway & Online
Symposium Dates: October 12–26, 2024
First published: 29 June 2024
Updated: 30 September 2026
Publisher Identification: ISSN 2371-8404