广州市长期照护机构老年人直接照护时长的影响因素研究

Study on influencing factors of the length of direct care for the elderly in long-term care institution in Guangzhou

目的:调查广州市长期照护机构的老年人直接照护时长现状及其影响因素,为长期照护机构合理配置护理人力资源、长期护理保险(长护险)试点城市制定受益人资格评估和待遇给付标准提供依据。方法:采用《长期护理失能等级评估标准(试行)》和老年人健康状况评估表对广州市长护险定点协议机构的484名老年人进行问卷调查,采用工时测量法对老年人的直接照护时长进行测量。结果:长期照护机构老年人24 h直接照护时长为(66.04±34.87)min,日常生活活动能力、认知能力、感知觉与沟通能力、是否有医疗护理项目是长期照护机构老年人直接照护时长的影响因素。结论:我国长期照护机构老年人直接照护时长受多种因素影响,长期照护机构应根据老年人的健康状况和照护需求合理分配护理人力资源,长护险试点城市应根据老年人的实际资源消耗量建立受益人准入门槛和制定待遇支付标准,从而更加客观公平地分配长期护理服务资源。

Objective:To investigate the current situation and influencing factors of the length of direct care for the elderly in long-term care institutions in Guangzhou,and to provide a basis for the rational allocation of nursing human resources in long-term care institutions and the formulation of beneficiary qualification assessment and treatment payment standards in pilot cities of long-term care insurance.Methods:A total of 484 elderly people in long-term care institutions in Guangzhou were investigated with the long-term Care Disability Rating Standard(trial)and the health status assessment scale for the elderly.The length of direct care for the elderly was measured by the Time and Motion Study.Results:The 24 h length of direct care for the elderly in long-term care institution was(66.04±34.87)min.The influencing factors included the ability of daily living activities,cognitive ability,sensory perception and communication ability,and whether there were medical care items.Conclusions:The length of direct care for the elderly in Chinese long-term care institutions is affected by many factors.Long-term care institutions should reasonably allocate nursing human resources according to the health status of the elderly and care needs,and long-term care insurance pilot cities should establish a beneficiary access threshold and formulate payment standards according to the actual resource consumption of the elderly,so as to allocate long-term care service resources more objectively and fairly.