中国市域老年失能照护机构发展及其供需适配性

老年失能照护是人口负增长时代的巨大挑战。文章结合多学科研究方法,刻画了老年失能分级照护机构的空间格局及密度差异,并揭示了其供需适配性的形成机制。研究发现:(1)中国老年失能照护机构数量总体呈现以北京、上海、广州为高值中心的分布格局,且高值区随照护分级的提升而逐渐收缩。(2)老年失能照护机构密度在不同区位、等级和规模的城市类型中有所差异,东部城市、直辖市和超大城市在所有失能分级下的发展优势均十分突出。(3)中国老年失能照护机构供需适配水平的空间分化迹象明显,总体表现为“东部繁荣、西部发展、中部塌陷”,且随着照护分级的提高,适配区向东部地区与省会城市集中。(4)供需适配格局受多种因素的共同影响,社会经济、支付能力和人口结构为空间分异的主导因子,其中人口结构与社会服务、医疗资源与交通条件的因子交互解释力最强。(5)各因素的影响效力存在区域差异,未来中国老年失能照护建设应充分考虑地区失能人口规模及结构特点,提供差别化的资源增补以弥合发展差异、实现社会公平。

Quality indicators for the care of older adults with disabilities in longterm care facilities based on Maslow’s hierarchy of needs

Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.