居家养老模式下老年人对社区卫生服务利用现状及评价

Utilization and evaluation of community health service in the elderly under the mode of home-based care for the aged

目的了解城市目前采取居家养老方式的老年人对社区卫生服务利用现状及评价,探讨在现有条件下社区卫生机构在居家养老方面可改进的方向。方法采用方便抽样方法 ,2015年7~12月利用自编问卷对全国1433名采用居家养老方式的城市老年人群进行调查,数据处理采用描述性分析和Logistic回归分析。结果老年人对社区卫生服务利用率尚可,有80%左右的老年人有社区卫生机构就诊的经历。回归分析结果显示,收入水平较低(P=0.0009,OR=2.1201)、医疗费用占总收入比重较高(P=0.0181,OR=0.5027)和子女配偶等一起居住(P=0.0100,OR=1.7564)的老年人更倾向于社区卫生服务机构就诊。70~<80岁年龄段的老年人和患3种及以上慢性病的老年人对社区卫生服务机构利用率最高。回归分析结果显示,慢性病数量是老年人评价社区卫生机构服务满意度的主要影响因素(P<0.05)。结论社区卫生机构有着广泛的群众基础,同时就医较方便、费用低廉,对于解决居家养老老年人群医疗护理需求起到至关重要的作用。考虑到不同居住情况以及健康状况的老年人对于医疗护理服务需求不同,今后应当更加重视老年群体个性化养护需求。

Objective To understand the status quo and evaluation of the use of community health services by the elderly in the city at present, to explore the improvement direction of community health institutions in terms of home care under existing conditions. Methods The method of convenience sampling was used. The self-made questionnaire was used to investigate 1433 elderly people in the country from July to December 2015. The data were analyzed by descriptive analysis and Logistic regression analysis. Results The community health service utilization rate was acceptable, 80% of the elderly had the experience of community health institutions treatment. The regression analysis showed that the el derly whose income was lower （P = 0.0009, OR = 2.1201）, medical expenses accounted for a higher proportion of total in come （P = 0.0181, OR = 0.5027） and who lived with children and their spouses （P = 0.0100, OR = 1.7564） were more in- clined to choose community health services. The elderly aged 70-〈80 or the elderly who was suffering from ≥ 3 kinds of chronic diseases had the highest utilization rate of community health services. The number of chronic diseases was the main influencing factor of the elderlys＇ satisfaction with community health services （P 〈 0.05）. Conclusion Community health institution plays a vital role in solving the nursing needs of home care for the elderly with its advantages of broad mass base, lower cost and close distance. Taking into account the different needs of medical care services with different living conditions and health status, community health institutions should pay more attention to the individual needs of the elderly.