未满足的照料需要对失能老年人多维健康的影响

The Impact of Unmet Needs on Health Among Chinese Older Adults with Disability

使用中国老年健康影响因素跟踪调查2005—2018年纵向数据,基于健康老龄化框架与生理-心理-社会医学模型,利用固定效应模型和工具变量,考察了未满足的照料需要对失能老年人生理、心理以及社会三个维度健康状况的影响,以验证未满足的照料需要对健康衰退的解释力,为未来进一步探索未满足的照料需要与健康老龄化之间关系奠定理论基础。未满足的照料需要对失能老年人多维健康具有消极影响,具体表现为:与照料需要得到满足的失能老年人相比,照料需要未得到满足的失能老年人的日常生活能力与认知能力更差,社会参与频率更低。未来应将未满足的照料需要作为老年人健康风险的预警指标,将其纳入老年人需求评估和长期照护服务质量评价指标体系,并将提供有效、充分的长期照护服务作为促进健康老龄化的干预方式。

Based on the data from Chinese Longitudinal Healthy Longevity Survey from 2005 to2018 and the theoretical frame work of healthy aging and physiology-psychology-social medicine model,this study applied the fixed effects logistic regression model and instrumental variable to examine the influence of unmet needs for assistance on activities of daily living,cognitive abilities,and social participation among older people with disability,respectively.This research revealed that older persons with disability who experienced unmet needs had higher risk of functional impairment in activities of daily living and cognitive abilities,and had less social participation than those with met needs.This research could set the basis for future studies to understand the relationship between unmet needs and the index of healthy aging.More policy attention should be paid to incorporating unmet needs into the needs assessment and establishing a precise service supply and subsidy mechanism based on unmet needs.In addition,it is necessary to increase awareness among gerontological practitioners with respect to LTC services and support for disabled older adults as a potential for enhancing their healthy aging.