家庭医生联合长护险照护对居家老年人疾病控制与生命质量的影响

The Influence of Family Doctor Combined with Long-term Care Insurance on Disease Control and Quality of Life of the Home-based Elderly

目的探讨家庭医生联合长期护理保险(长护险)照护对居家老年人疾病控制与生命质量的影响。方法2021年5-7月选择上海市大场镇长护险中重度评级的居家老年人98例,将其随机分为两组,长护险组48例接受常规照护,联合组50例增加家庭医生团队服务。采用χ^(2)检验或t检验比较照护前和照护6月后老年人疾病控制情况、日常生活能力(ADL)、老年抑郁量表(GDS)、简明健康状况调查表(SF-36)评分。结果联合组照护后糖尿病达标率明显提高。照护后两组ADL评分均显著提高,GDS评分均显著降低,联合组变动幅度大于长护险组,差异有统计学意义(P<0.05)。在SF-36评分方面,照护后联合组生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、精力(VT)、社会功能(SF)、精神健康(MH)评分升高幅度大于长护险组,其中VT、SF、MH差异有统计学意义(P<0.05);照护后两组生理健康和心理健康评分均显著升高,组间比较差异有统计学意义(P<0.05)。结论在长护险照护基础上增加家庭医生医疗服务,更能有助于居家老年人慢性病尤其是糖尿病的控制,更有效改善老年人日常生活能力、抑郁状态和整体生命质量。

Objective To explore the influence of family doctor combined with long-term care insurance(LTCI)on disease control and quality of life of the home-based elderly.Methods From May to July 2021,98 home-based elderly with moderate to severe rating of LTCI in Dachang Town were selected and randomly divided into two groups.48 patients in the LTCI group received routine care from nursing staff,and 50 patients in the combined group received additional family doctor team services.χ^(2)-test or t-test were used to compare the scores of disease control,Activity of Daily Living Scale(ADL),Geriatric Depression Scale(GDS),and 36-Item Short From Survey(SF-36)before and 6 months after care.Results The control rate of diabetes in the LTCI group was not significantly improved,while that in the combination group was significantly improved,and the difference between the two groups was statistically significant(P<0.05).After care,the ADL scores and GDS scores of the two groups were significantly improved,and the improvement range of the combined group was greater than that of the LTCI group,with statistical significance(P<0.05).In terms of SF-36,PF,RP,BP,VT,SF and MH scores of the two groups increased after care,and the increase range of the combined group was greater than that of the LTCI group,and the difference of VT,SF and MH was statistically significant(P<0.05).Overall,physical health and mental health scores of the two groups increased significantly,and the difference between the groups was statistically significant(P<0.05).Conclusion Family doctors combined with long-term care insurance is more conducive to control of diabetes among the home-based elderly,and more effectively improve the elderly'daily living ability,depression state and overall quality of life.