居家社区医养结合服务利用及满意度现状研究

Research on the Utilization and Satisfaction Status of Integrated Medical and Elderly Care Services in Home and Community

目的 了解居家社区医养结合服务的利用情况和满意度现状,提出促进医养结合发展的对策和建议。方法 通过目的抽样法于2023年5-7月在我国东、中、西部分别选取无锡市、长沙市、成都市对2 125名60岁及以上正在接受或曾接受过服务的老年人进行问卷调查。采用描述性分析、卡方检验、单因素方差分析、多元线性回归等统计学方法对有效问卷数据进行分析。结果 不同地区的就医习惯、服务方式、常用药的获取情况差异具有统计学意义(P<0.05)。服务总体满意度均值为(4.32±0.625)分,处于“满意”与“非常满意”之间。线性回归结果显示,失能程度、慢性病患病情况、地区差异、就医习惯、服务方式、常用药获取情况、地理可及性情况是服务满意度的影响因素(P<0.05)。结论 老年人所接受的居家社区医养结合服务对于基层医疗卫生机构利用情况较好,服务总体满意度较高,但存在地区之间发展不平衡的问题。应进一步以基层医疗卫生机构为重点发展居家社区医养结合服务,完善医保支付机制,加快建立健全长护险制度,不断提高居家社区老年人的满意度和居家社区医养结合服务质量。

Objective To understand the utilization and satisfaction status of integrated medical and elderly care services in home and community,and propose measures and suggestions to promote the development of integrated medical and elderly care.Methods A purposive sampling method was adopted from May to July 2023.A total of 2 125 older adults aged 60 and above,receiving or having received services from Wuxi city of Jiangsu province,Changsha city of Hunan province.and Chengdu city of Sichuan province,were surveyed using a questionnaire.Descriptive analysis,chi-square test,One-way ANOVA analysis,and multivariable linear regression were used to analyze the questionnaire data.Results There were statistically significant differences in general medical habits,service mode,and access to commonly used drugs across different regions(P<0.05).The average overall satisfaction score of the service was(4.32±0.625),which was between "satisfied" and "very satisfied".According to the results of linear regression analysis,disability level,chronic disease status,regional difference,preference of receiving medical treatment,service mode,access to commonly used drugs,and geographical distance were the influencing factors of satisfaction with integrated medical and elderly care services in home and community(P<0.05).Conclusion The integrated of medical and elderly care services received by the older adults are well utilized by primary medical and health institutions,and the overall satisfaction with the services is high,but there is a problem of unbalanced development between regions.It is necessary to further improve the capacity of primary care services,and adjust the payment methods of medical insurance,accelerate the establishment and improvement of long-term care insurance system,so as to continuously improve the satisfaction of the community-dwelling elderly and the quality of integrated medical and elderly care services in home and community.