社区老年人医养结合服务需求现状及其影响因素研究

Study on the current situation of demand for the integration of medical and elderly care services in communities and its influencing factors

[目的]从需方角度出发了解新疆社区老年人医养结合服务需求现状,并分析其影响因素,为更好地提供医养结合服务以及提高老年人生活质量提供依据,同时为制定健康养老相关政策提供参考。[方法]通过方便抽样选取新疆5个医养结合试点地区60岁以上老年人共600人进行现场问卷调查,通过单因素及Logistic回归分析影响老年人医养结合服务需求的相关因素。[结果]老年人需求得分前4位依次是医疗服务类(3.35±0.455)、中医药服务类(3.10±0.196)、护理服务类(2.99±0.231)、基本服务类(2.99±0.050)。年龄、职业、婚姻状态、居住方式、月收入、月支出、身体健康状态、生活自理情况、所患慢病种数这9个因素对需求总分的影响差异有统计学意义(P<0.05)。生活自理情况(t=9.470,P<0.001)、婚姻状况(t=6.316,P<0.001)、职业(t=-5.657,P<0.001)、所患慢病种数(t=3.640,P<0.001)、月收入(t=-3.320,P=0.001)这5个因素是影响老年人需求总得分的主要因素。[结论]新疆社区老年人医养结合服务需求水平较高;不同特征老年人具有不同程度的医养结合服务需求特点;老年人自理状况对老年人医养结合服务需求影响最大,应通过健全医疗保障制度、加大政策宣传力度、丰富医养结合服务内容等手段全面促进医养结合模式健康、持续发展。

Objective To understand the current situation of demand for the integration of medical and elderly care services in Xinjiang communities from the perspective of demand and to analyze its influencing factors, so as to provide better services of integration of medical and elderly care and improve the quality of life of the elderly, and to provide reference for formulating health care policies.Methods A total of 600 elderly people over 60 years old were selected in 5 pilot areas of the integration of medical and elderly care services in Xinjiang by convenience sampling to conduct on-site questionnaire survey, and the influencing factors of the demand for the integration of medical and elderly care services were analyzed by univariate and logistic regression.Results The top four in terms of the needs of the elderly were medical services(3.35±0.455),Chinese medicine services(3.10±0.196),nursing services(2.99±0.231)and basic services(2.99±0.050). There was statistical significance for the nine factors on differences of total demand scores(P<0.05):age, occupation, marital status, mode of residence, monthly income, monthly expenditure, physical health status, self-care status, and the number of chronic diseases suffered. The main factors influencing the total score of demands of the elderly were self-care status(t=9.470,P<0.001),marital status(t=6.316,P<0.001),occupation(t=-5.657,P<0.001),the number of chronic diseases(t=3.640,P<0.001),and monthly income(t=-3.320,P=0.001).Conclusions Firstly, the demand for the integration of medical and elderly care services in Xinjiang communities is high. Secondly, the elderly with different characteristics have different degrees of demand for the integration of medical and elderly care services. Thirdly, the self-care status of the elderly has the greatest impact on the demand for the integration of medical and elderly care services. The government should comprehensively promote the sound and sustainable development of the model of the integration of medical and elderly care services by improving the medical security system, increasing policy publicity and enriching the content of the integration of medical and elderly care services.