1389名老年人对社区居家医养结合养老服务模式的选择意愿及影响因素分析

doi:10.16460/j.issn1008-9969.2021.04.050

摘要/Abstract

摘要： 目的调查老年人对社区居家医养结合养老服务模式的选择意愿,分析其影响因素。方法 2017年9月—2018年5月,抽取经济和人口特征不同且具有代表性的3个城市,每个城市中选择具有代表性的2~3个区/县,每个区/县中选取具有代表性的2~3个街道/乡镇,每个街道/乡镇中选择1~2个具有代表性的社区/村。采用计算机随机抽样法在每个社区/村内抽取老年人,最终共抽取1 389名老年人作为研究对象。引入安德森行为模型作为分析框架,采用二元Logistic回归模型分析先决、促能和需求三类因素对老年人选择医养结合养老服务模式的影响。结果 1 389名老年人中,1 172名（84.38%）老年人更倾向于选择社区居家医养结合养老服务模式。二元Logisitc回归分析显示,影响老年人选择社区居家医养结合养老服务模式主要包括3个先决因素：性别（OR=1.478,P=0.016）、退休前职业（OR=2.388,P<0.001）、文化程度（OR=2.037,P<0.001）,2个促能因素：子女数量（1~2人组：OR=3.857,P=0.005;≥3人组：OR=6.870,P<0.001）、社区有无医疗服务（OR=2.157,P<0.001）,1个需求因素：过去1月就医次数（OR=1.863,P<0.001）。结论社区居家医养结合养老服务模式更加符合我国养老传统和健康老龄化的理念。未来我国的养老政策应强化社区居家医养结合养老服务的基础地位,更多地集中于为女性、农林牧渔水利业等生产人员、小学及以下文化水平、子女数量较多、社区医疗服务健全、就医需求较小的老人提供社区居家养老服务,并积极推进医养结合养老服务入社区和入户。鉴于我国医护人员和养老照护人员的不足,建议在精准确定服务对象的基础上,针对不同服务对象的实际需要提供差异化服务。

关键词: 社区居家, 医养结合, 养老服务, 安德森行为模型

Abstract: Objective To investigate the elderly's willingness for community-homemedical care combined with pension service, and to analyze its influence factors. Methods From September 2017 to May 2018, selected 3 representative cities with different economic and demographic characteristics, selected 2 to 3 representative districts/counties in each city, and selected from each district/county with 2 to 3 representative streets/towns, and 1 to 2 representative communities-villages in each street/town. The computer random sampling method was used to select the elderly in each community-village, and finally 1,389 elderly were selected as the research objects.The Anderson behavior model was introduced, and the binary Logistic regression model was used to analyze the influence of the three factors of prerequisite, energy-promotingand demand on the elderly's choice of community-homemedical care combined with pension service. Results Among the 1,389 elderly people, 1,172 (84.38%) were more inclined to choose community-homemedical care combined with pension service. Binary logisitc regression analysis showed that the influence factors of the choice included three prerequisite factors: gender (OR=1.478, P=0.016), pre-retirement occupation (OR=2.388, P<0.001), education background (OR=2.037, P<0.001); two can-promote factors: number of children (1~2 children group: OR=3.857, P=0.005; ≥3 children group: OR=6.870, P<0.001) and the availability of community medical service (OR=2.157, P<0.001); and one need factor of number of medical visits in the past month (OR=1.863, P<0.001). Conclusion community-homemedical care combined with pension service is in line with the tradition and healthy aging in China. Community-homemedical care combined with pension service is supposed to be promotedparticularly for women;the elderly with pre-retirement occupation in the field of agriculture, forestry, animal husbandry, fishery and water conservancy; those less-educated; those having more children, and those living in community with sound medical service and having less need for medical treatment. Targeted and demand-oriented serviceare beneficial to satisfy the need of the elderly people in view of the shortage of nursing staff in China.

Key words: community home-based, combination of medical and nursing care, elderly care service, Anderson Behavior Model

中图分类号:

R473.2

支梦佳, 季佳林, 胡琳琳. 1389名老年人对社区居家医养结合养老服务模式的选择意愿及影响因素分析[J]. 护理学报, 2021, 28(4): 50-56.

ZHI Meng-jia, JI Jia-lin, HU Lin-lin. Willingness of Elderly People for Community-home Medical Care Combined with Pension Services and Its Influence Factors: A 1,389-case Study[J]. Journal of Nursing, 2021, 28(4): 50-56.

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