老年自评健康影响因素在不同养老模式间的差异分析

Analysis on influence of self-rated health status of the aged under different care modes

目的调查3种养老模式(居家养老、机构养老、医养结合养老)老年人自评健康状况,分析其影响因素,为提高老年人健康水平、优化和改进养老模式的健康管理细节,提供具有现实指导意义的应用建议。方法2019年9-10月在乌鲁木齐市3种不同养老模式下进行问卷调查。其中居家养老纳入332人,机构养老纳入325人,医养结合养老纳入233人。问卷内容包括基本情况、养老需求、自评健康状况等,通过有序回归模型探索3种养老模式老年人自评健康状况的影响因素。结果老年人自评健康总体呈现较积极的状态,在居家养老中,有子女经济支持的老年人自评健康状况越好;机构养老中,就医便利的老年人自评健康水平较好;医养结合养老中,医疗花费占总收入比例/年为20%~40%、接受长期照护服务、接受疾病监测的老年人健康状况较好。控制变量中,60~70岁、已婚且与配偶同住、经常自我保健的老年人健康状况较好。结论老年人是健康管理的重点人群,应根据不同养老模式开展针对性的健康管理措施,同时推进医、养在功能上实现融合,提高老年人群的健康状况。

Objective To investigate the self-rated health status of the elderly in three modes of old-age care and analyze its influencing factors,and to protect the elderly endowment mode,optimize and improve the health level of health service details to provide realistic guiding significance to the application suggestion.Methods From September to October in 2019,a questionnaire survey was conducted under three different pension modes in Urumqi.Among them,332 were home-based care,325 were institutional care,and 233 were medical combined with old-age care.The questionnaire includes basic information,pension needs,self-rated health status as well.The influencing factors of self-rated health status of the elderly in three pension modes are explored through ordinal regression model.Results The selfassessed health of the elderly is generally in a positive state.In the home-based care,the older people who have the children’s economic support have better self-rated health status;in the institutional care,self-evaluated health is better for the elderly with convenient medical treatment;in the combination of medical care and old-age care,the higher proportion of medical expenses to total income and the acceptance of long-term care services can improve the self-rated health status of the elderly.In the control variables,the older the elderly,the lower the health level;for the married and living with their spouses,self-care can improve the health level of the elderly.Conclusion The elderly are the key population of health management.Therefore,different elderly care models should carry out targeted health management measures,meanwhile promote the integration of medical and nursing functions to improve the health of the elderly.