上海市长期护理保险参保老年人生活质量状况及影响因素分析

A Study on the Quality of Life and Influencing Factors of Elderly Participating in Long-term Care Insurance in Shanghai

目的:为积极应对人口老龄化,2018年上海市在全市推广长期护理保险(以下简称长护险),探究上海市长护险参保老年人生活质量并分析其影响因素。方法:采取分层随机抽样法,抽取上海市6个长护险试点区的2~6级长护险1871名老年人为调查对象,调查内容包括社会人口学情况、卫生服务及长期护理服务利用情况,并通过单因素分析及多元线性回归明确生活质量的影响因素。结果:上海市长护险参保老年人平均生理综合评分为(31.04±7.97)分,平均心理综合评分为(41.24±9.55)分。多元线性回归结果显示,贫困户、长护险类型为机构长护险、申请了2次评估等的长护险参保老年人生理综合评分较好。月收入较低、日常生活治理能力较好、最新评估等级为6级以下的长护险参保老年人心理综合评分较好。结论:上海市长护险参保老年人的生理综合评分及心理综合评分均低于普通社区老年人。建议进一步提高居家长护险服务水平,改善老年人的生活自理能力,加强认知功能干预以及提高社会对长护险老年人的关注。

OBJECTIVE In response to the challenges posed by an aging population,Shanghai municipality initiated the widespread implementation of long-term care insurance in 2018.The research aims to explore the quality of life among elderly participants in Shanghai’s long-term care insurance program and analyze the factors influencing their well-being.METHODS The study employs a stratified random sampling method,selecting 1871 participants from six pilot areas with long-term care insurance levels ranging from 2 to 6.The investigation encompasses demographic information,utilization of health services,and long-term care services.Single-factor and multiple linear regression analyses are conducted to identify factors affecting the quality of life.RESULTS The surveyed elderly participants in Shanghai’s long-term care insurance program achieved a physical health score of 31.04±7.97 and a psychological health score of 41.24±9.55.Following multiple linear regression analysis,elderly participants in long-term care insurance who were identified as impoverished,enrolled in institutional long-term care insurance,and underwent secondary assessments exhibited better physical health-related quality of life.Additionally,those with lower monthly incomes,better daily life management abilities,and assessment levels below 6 in their most recent evaluation displayed superior psychological health-related quality of life.CONCLUSION The physical and mental health-related quality of life for elderly participants in Shanghai’s long-term care insurance program is found to be lower than that of ordinary community-dwelling elderly individuals.The study recommends further enhancement of home-based long-term care insurance services,focusing on improving elderly individuals’self-care abilities,implementing cognitive function interventions,and increasing societal awareness and concern for those enrolled in long-term care insurance.