珠海市医养结合养老服务模式现状及对策分析

Status quo and countermeasures of integration of medical care and pension in Zhuhai

目的 探讨珠海市医养结合养老服务模式现状,并提出相关对策,旨在为珠海市养老服务模式的完善提供参考。方法量性研究:利用便利抽样法抽取珠海市3家养老中心内共120名老人以及每个中心的1名主要管理者进行问卷调查,对所得数据进行描述性统计分析和χ~2检验。质性研究:采用目的抽样法抽取珠海市3家养老中心的6名老人和3名中心主要管理者进行半结构式深入访谈,应用Colaizzi七步分析法和类属分析法分析访谈资料。结果 3家养老中心面临的困难都是人力资源匮乏、资金困难。3家养老中心的老人年龄主要集中在70岁以上,其中42%为80~89岁,29%为90~99岁,21%为70~79岁;70岁以下的老人很少,占6%,其中60岁以下的老人最少,占1%。入住养老中心的老人中54%为女性,46%为男性,男女比例接近1∶1。比较健康,无疾病困扰的老人占15.0%(18/120),患有慢性病的老人占30.8%(37/120),长期卧床不起的老人占54.2%(65/120)。对老人的访谈结果:认知程度低;存在健康问题。对中心主要管理者的访谈结果:专业型人才匮乏;资金困难。结论 基于珠海市医养结合养老服务模式现状,结合相关文献,提出针对性对策:多元化筹资和个性化服务以应对资金困难的困境,多维度培养和吸引专业型人才以解决专业型人才匮乏和人才待遇与职称晋升体系未完善的问题,加大医养结合的宣传力度和关注老人心理健康以提高群众对医养结合服务的认知程度,多方面提高护理人员职业的社会认同感以增加护理人员的社会支持。

Objective To explore the Status quo of integration of medical care and pension in Zhuhai and put forward relevant countermeasures,in order to provide guidance for the improvement of the elderly care service model in Zhuhai.Methods A total of 120 elderly people from three elderly care centers in Zhuhai city and one main administrator from each center were selected by convenience sampling for a questionnaire survey.The obtained data were analyzed descriptively and χ^(2) test was performed.For the qualitative study,six elderly people and three main administrators from three elderly care centers were selected by purposive sampling method for semi-structured in-depth interviews.The Colaizzi seven-step analysis method and class analysis method were adopted to analyze the interview data.Results The difficulties faced by the three elderly care centers were a lack of human resources and financial difficulties.The age of the elderly in the three elderly care centers was mainly above 70 years,of which 42%were 80-89 years old,29%were 90-99 years old,and 21%were 70-79 years old.There were few elderly people under 70 years old,accounting for 6%,of whom the elderly under 60 years old were the least,accounting for 1%.Fifty-four percent of the elderly admitted to elderly care centers were female and 46%were male,with a male to female ratio of nearly 1∶1.A total of 15.0%(18/120)of the elderly were in good conditions and had no afflicting disease,30.8%(37/120)had chronic diseases,and 54.2%(65/120)were bedridden for a long time.Interviews with the elderly showed that they had low awareness and health problems.Interview results with key administrators of the center indicated a lack of professional talent and funding difficulties.Conclusion The targeted countermeasures are proposed based on the current theoretical model of integration of medical care and pension in Zhuhai in combination with the relevant literature.The relevant departments should diversify financing and personalized service to cope with the dilemma of financial difficulties,strengthen multi-dimensional training and attract professional talents to solve the problems of lacking talents and imperfect talent benefits and professional title promotion system.They should also intensify the publicity of the integration of medical care and pension and pay attention to the mental health of the elderly to improve the public’s awareness of the pension mode.The social identity of nursing staff’occupations should be improved in many aspects to increase their social support.