失能老人健康状况和卫生服务需求的相关回归分析

目的探讨江汉油田失能老人健康状况和卫生服务需求及影响因素。方法采用整群抽样,使用自设问卷、健康状况自评表、日常生活能力量表（ADL）对江汉油田5个社区60岁及以上的3 343名老年人进行面对面问卷调查。结果 （1）老年人失能率13.88%,失能老人健康自我评价为较差和很差占82.3%、慢性病患病率92.95%、调查前2周患病率30.4%、1年住院率38.2%。（2）二分类Logistic回归分析显示,影响失能老人2周就诊的促进因素的OR值及95%CI分别是：年龄2.090（1.076-4.059）、体重指数1.677（1.114-2.524）、患慢病数1.457（1.087-1.953）;限制因素是两周是否患病0.109（0.063-0.189）、去医院时间0.167（0.098-0.287）。（3）影响失能老人1年住院的促进因素的OR值及95%CI分别是：患慢病数1.429（1.120-1.824）、是否参加医保1.500（1.154-1.951）、收入状况1.596（1.003-2.541）;抑制因素有失能程度0.641（0.474-0.867）、婚姻状况0.702（0.507-0.972）。结论失能老人健康状况比较差,慢性病患病率高,对失能老人应开展针对性的社区卫生服务、康复护理、健康促进,满足失能老人的卫生服务需求,有利于改善健康水平和生活质量。

Objective To investigate the health status and the demands of community health services for the elderly disability of jianghan oilifeld, evaluate the inlfuencing factors in selecting the requirement of health services. Methods The cluster sampling used, 3 343 elderly people, aged 60 or more, from 5 communities in Jianghan Oilifeld, were nvestigated face to face through self designed questionnaire, health status self-evaluating table and activity of daily living （ADL）. Results （1） The rate of disabled elderly was 13.88%, the results which were poor and very poor in health state self-assessment of the elderly disability was 82.3%, the rate of chronic disease was 92.95%, the two-week prevalence rate was 30.4%, the admission rate was 38.2%. （2） Through binary Logistic regression analysis, the odds ratio and 95%CI of inlfuencing two-week prevalence accelerated factors appeared to be：age as 2.090 （1.076-4.059）;body mass index （BMI） as 1.677 （1.114-2.524）;the number of chronic non-infectious disease as 1.457 （1.087-1.953）. Odds ratio and 95%CI on astricted factors appeared to be：two-week prevalence rate as 0.109 （0.063-0.189）;the time going to hospital as 0.167 （0.098-0.287）. （3） the odds ratio and 95%CI of inlfuencing the admission rate accelerated factors appeared to be：the number of chronic non-infectious disease as 1.429 （1.120-1.824）;purchasing medical insurance as 1.500 （1.154-1.951）;income as 1.596 （1.003-2.541）. Odds ratio and 95%CI on limited factors appeared to be：the degree of disability as 0.641 （0.474-0.867）;the marital status as 0.702 （0.507-0.972）. Conclusion The elderly disability was inferior in health status and morbidity of chronic non-infectious disease was relatively higher. We should energetically develop targeted community health service, rehabilitation nursing, health promotion, enhance the health level and the quality of life.