杭州市某区老年人医养结合服务供需现状及影响因素分析

Survey and analysis on the demands and supply of the elderly care with medical support in Hangzhou

目的了解杭州市某区社区老年人医养结合服务需求和供给现状，并分析其影响因素。方法2017年10—11月，采用二阶段分层随机抽样法选取杭州市江干区3个街道12个社区1416名老年人进行问卷调查。结果有医疗服务需求的社区老年人中，看病在社区、买药在社区和每年健康体检3项服务需求得到满足的比例最高，分别为70．4％、67．1％和64．0％，其余8项医疗服务需求得到满足的比例均〈30％；有社区照护服务需求的老年人中，9项照护服务项目需求得到满足的比例均低于30％；有康复需求的老年人中，6项社区康复服务得到满足的比例均〈15％。年龄、自理能力和患病种数是社区老年人医养结合服务需求的主要影响因素（P〈0．05）。结论社区医养结合服务供给与需求存在差距，医疗、照护和康复服务等医养结合服务需大力发展。高龄、自理能力下降和患多种疾病老人应是关注的重点。

Objective To understand the demands of elderlies in a community in Hangzhou for the elder care with medical support and the current supply, and analyze the influencing factors. Methods A questionnaire survey was conducted among 1 416 elderlies at 12 communities of 3 neighborhoods in Jianggan district of Hangzhou city, using stratification sampling. Results For the elderlies with demands for medical care, such services as medical advice in community, pharmacy in community and annual physical examination were made available and the highest satisfactions, being 70. 4%, 67. 1% and 64. 0% respectively. In contrary, less than 30% of the rest eight medical care demands were met. For the elderlies with demands for nursing care in community, supply of nine elderly care services fell below 30%. For the elderlies with demands for rehabilitation services, supply of six community rehabilitation services fell below 15%. Age, self-care ability and the number of chronic diseases were the main factors affecting old people＇s demand for medical-nursing combined care （P 〈 0.05 ）. Conclusions A gap is found between elderlies＇ demands for elderly care with medical support and the services available. Medical care, nursing care and rehabilitation service deserve further development efforts. Those of advanced age, with declining self-care ability, and those afflicted with many diseases should attract major attention.