我国60岁及以上老年人口养老意愿及选择居家养老的影响因素分析

Elserly people′s pension willingness and influencing factors of choosing home-based care of population aged 60 and above

目的了解60岁及以上在家居住的老年人口的养老意愿及影响老年人口居家养老意愿选择的因素,为改善老年人口生活状况、更好地为其提供全周期的服务,促进健康老龄化提供依据。方法利用全国第六次卫生服务统计调查的数据,分析不同地区、不同家庭状况、不同社会人口学特征、不同失能状况的老年人口的照护情况和养老意愿,利用logistic回归分析影响老年人选择居家养老的影响因素。结果11.8%的老人日常生活需要照顾,日常照顾52.5%的由配偶提供,42.9%的由子女提供。90.7%的老年人倾向于居家养老,城乡、性别、年龄、婚姻状况、文化程度、家庭经济状况、失能情况、患慢病种数、家庭规模都是影响老人养老意愿的影响因素:希望居家养老的概率,城市地区老人低于农村地区(OR=0.625,95%CI:0.589~0.663);男性高于女性(OR=1.122,95%CI:1.062~1.187);70~79岁(OR=1.219,95%CI:1.147~1.296)、80岁及以上老人(OR=1.598,95%CI:1.433~1.782)均高于60~69岁老人;未婚(OR=0.476)、离婚(OR=0.600),均低于已婚老人;小学(OR=0.742)、初中(OR=0.437)、高中及以上(OR=0.352)学历老人均低于没上过学的老人(P<0.01);家庭人口数在2口及以上的老人高于独居老人(P<0.01);中度失能(OR=1.159)、重度失能(OR=1.241)老人高于不失能老人(P<0.01)。结论年龄大、文化程度低、家庭经济状况差、失能情况严重、家庭规模大的老人希望居家养老的概率更高。结合老年人的养老意愿,针对不同老年人的健康状况、护理与照料需求,建立和完善以家庭为依托的养老服务体系,并探索长期护理制度设计,保障老年人的健康权益。

Objective To learn about the pension willingness and factors affecting the choice of home care willingness of the elderly population,and to provide the evidence for improving life status of the elderly population,better providing full cycle services,and promoting healthy aging.Methods Data of the Sixth National Health Service Statistical Survey were used to analyze the nursing situation and pension willingness of the elderly population in different regions,different family conditions,different social demographic characteristics and different disability status,and logistic regression was used to analyze the influencing factors of the elderly population′s choice of home-based care.Results Eleven point eight percent of the elderly needed to be taken care of for their daily life,and daily care was provided 52.5%by spouses and 42.9%by children.And 90.7%of the elderly were inclined to home-based care,urban and rural areas,sex,age,marital status,educational level,family economic status,disability degree,the number of chronic diseases,family size were all influencing factors of elderly pension willingness.The probability of wanting home care was lower in urban areas than in rural areas(OR=0.625,95%CI:0.589-0.663);it was higher for men than for wornen(OR=1.122,95%CI:1.062-1.187);and it was higher for 70-79 years old(OR=1.219,95%CI:1.147-1.296)and 80 years old and above(OR=1.598,95%CI:1.433-1.782)than for 60-69 years old;it was lower for unmarried(OR=0.476)and divorce(OR=0.600)than for married;it was lower for the elderly with educational levels of primary school(OR=0.742),junior middle school(OR=0.437),and senior high school or above(OR=0.352)than for those without literacy(P<0.01);it was higher for elderly people not living alone than for those living alone(P<0.01).Conclusion The elderly with older age,lower educational level,poor family economic status and large family size are more likely to hope for care at home.Combined with the elderly′s pension willingness,in view of the health status,nursing and care needs,it is necessary to establish and improve a service system based on family care,to explore the design of long-term care system,and to protect the health rights and interests of the elderly.