独居与非独居老年人居家照护未满足需求的比较研究

A comparative study on the unmet needs of home care and the willingness to purchase services of the elderly living alone and non-living alone

目的对比北京市城市社区独居与非独居老年人居家照护需求未满足状况以及服务购买意愿方面的差异,为制订有针对性的居家养老服务对策提供参考。方法于2017年2月—8月采用便利抽样的方法对北京市的5457名居家老年人进行问卷调查,采用倾向性评分匹配的方法将独居老年人与非独居老年人进行1:1匹配后,比较两者居家照护未满足需求及服务购买意愿的差异。结果经倾向性评分匹配后,共1072名居家老年人(独居/非独居老年人各536名)纳入比较分析,结果显示,独居老年人的躯体性日常生活照护未满足需求比例(17.4%)、工具性日常生活照护未满足需求比例(21.9%)、疾病管理未满足需求比例(42.6%)及社会支持未满足需求比例(33.2%)高于非独居老年人,差异有统计学意义(P<0.05);愿意购买照护服务的老年人中,独居老年人在健康指导(65.5%)、上门服务(58.3%)、紧急救援(61.9%)和家政服务(63.2%)4个项目上的购买意愿比非独居老年人更为强烈(P<0.05)。结论与非独居老年人相比,独居老年人居家照护未满足需求和服务购买意愿集中于日常生活照护、疾病与健康管理、安全照护及社会支持方面。要针对独居老年人的居家照护未满足需求制订有针对性的居家照护策略,从而有效降低独居老年人居家照护的未满足需求比例,提高其健康水平和生活质量。

Objective To compare the differences in the unmet needs of home care and the purchase intention of home care services between the elderly living alone and non-living alone in urban communities in Beijing,and to provide references for the development of targeted home care service countermeasures. Methods A convenience sampling method was used to conduct a questionnaire survey of 5 457 home-based elderly people in 6 urban areas of Beijing from February to August 2017. The propensity score matching method(PSM) was used to match the elderly living alone with the elderly non-living alone at 1∶1,and the differences in the unmet needs of home care and the willingness to purchase services between the 2 groups were compared. Results After PSM matching,a total of 1072 elderly people living at home(536 each living alone/not living alone)were included in the comparative analysis. The results showed that the proportion of unmet care needs of physical daily care(17.4%),instrumental care(21.9%),disease management(42.6%) and social support(33.2%) of the elderly living alone were higher than those of the elderly non-living alone,and the differences were statistically significant(P<0.05). Among the elderly who are willing to purchase care services,compared with the elderly who are not living alone,the elderly living alone have a stronger willingness to purchase several items of health guidance(65.5%),door-to-door service(61.9%),emergency assistance(63.2%) and housekeeping service(63.2%) than those who are not living alone(P<0.05). Conclusion Compared with the elderly non-living alone,the unmet needs of home care for the elderly living alone and their willingness to purchase services mainly focus on the aspects of daily life care,disease and health management,safety care and social support. Aiming at the unmet needs of home care for the elderly living alone,we should formulate targeted home care strategies,so as to effectively reduce the proportion of insufficient needs of home care for the elderly living alone,and improve their health level and quality of life.