基于优劣尺度法的老年人居家照护服务选择偏好及支付意愿分析

Analysis of Elderly Individuals'Choice Preference and Willingness to Pay for Home Care Services Based on Best-Worst Scaling

目的探析老年人对居家照护服务的选择偏好及支付意愿,为推动长期护理保险制度及养老服务健康发展提供参考。方法基于优劣尺度法设计问卷,通过条件Logit回归分析老年人对居家照护服务各属性的选择偏好及老年人个体特征对其偏好的影响,并计算支付意愿。结果以个人自付额为参考,老年人对居家照护服务的选择偏好为:服务内容>服务质量>是否对服务过程进行监督或收集反馈意见(P均<0.05)。其中,老年人更偏好兼具生活照料和医疗护理的服务内容、较高的服务质量、能够进行监督或收集反馈意见的服务过程,并愿意为此分别多支付318.496元、767.508元、617.512元。老年人居家照护服务需求程度、子女数量和月均收入的差异会影响其选择偏好。结论居家照护服务发展应着力于居家医疗护理服务推广、服务质量提高和服务过程精细化管理。

Objective To explore the choice preference and payment willingness of older adults for home care services,and provide reference for promoting the healthy development of long-term care insurance system and elderly care services.Methods A questionnaire was designed using the best-worst scaling method.Conditional Logit regression was used to analyze the choice preference of the elderly for each attribute of home care service and the influence of individual characteristics of the elderly on their preference,and the willingness to pay was calculated.Results Using out-of-pocket costs as reference,elderly individuals ranked the importance of various attributes as follows:service content>service quality>supervision or feedback in service provision(all P<0.05).Specifically,elderly individuals preferred service content that combines daily living assistance and medical care,higher service quality,and service provision that allows for supervision or feedback,and they were willing to pay an additional￥318.496,￥767.508,and￥617.512,respectively,for these attributes.The demand of older adults for home care services,the number of children and the average monthly income would affect the choice preference of the elderly.Conclusion The development of home care services should focus on promoting home-based medical care services,improving service quality,and enhancing the fine management of service processes.