Needs of Home-based Health Services Delivered by Community Healthcare Institutions among China's Elderly People

doi:10.12114/j.issn.1007-9572.2019.00.528

Abstract

Abstract: Background　Community healthcare institutions（CHIs）are a top priority for China's medical reform.Home-based health services are a type of featured services delivered by CHIs.Identifying the overall needs and intersubgroup differences in needs of home-based health services among the elderly is conducive to the formulation of regimens for the delivery of home-based health services.Objective　To investigate the status and features of overall needs and intersubgroup differences in needs of home-based health services delivered by community healthcare institutions among China's elderly people.Methods　Participants were 7 626 older adults selected from the respondents of 2014 China Longitudinal Aging Social Survey（CLASS）．Analysis was performed on their needs of home-based health services delivered by community healthcare institutions including home-based nursing care，consultation and rehabilitation.Logistic regression was used to analyze the influencing factors of home-based health service needs of elderly.Results　22.83%（1 741/7 626）of the participants needed home-based health services delivered by community healthcare institutions.Among them，the most needed〔91.96%（1 601/1 741）〕was home-based consultation.The needs of home-based nursing care，consultation，and rehabilitation were significantly different among different age groups.Home-based consultation was more needed in those who were much older and those living in rural areas and urban village communities.In those born in 1934 and earlier，gender，preferred place for living after retirement，current living arrangement，number of houses owned，place of residence，and community type were the influencing factors of needs of home-based health services（P<0.1）．In those born from 1935 to 1944，self-rated health status，main source of livelihood，place of residence，and community type were the influencing factors of needs of home-based health services（P<0.1）．In those born from 1945 to 1954，gender，marital status，education level，self-rated health status，preferred place for living after retirement，current living arrangement，and community type were the influencing factors of needs of home-based health services（P<0.1）．Conclusion　The rate of needing home-based health services delivered by community healthcare institutions among China's elderly people is low，which is associated with birth year，living environment，individual preferred status for living after retirement and other special personal characteristics.

Key words: Aged, Community health services, Community medical institution, Home-based service, Home-based consultation, Home-based nursing care, Rehabilitation, Cohort studies

摘要： 背景　社区医疗机构是中国医疗改革任务的重中之重，上门服务是社区医疗机构的特色服务之一，明确老年人的社区医疗机构上门服务需要现状和人群差异有利于制定社区医疗机构上门服务方案。目的　探讨我国老年人社区医疗机构上门服务需要的现状、特点，揭示老年人社区医疗机构上门服务需要的内部差异。方法　选取2014年“中国老年社会追踪调查”（CLASS）数据中的7 626例老年人作为研究对象，分析老年人需要社区医疗机构上门服务的类型，包括上门护理、上门看病和康复治疗。采用Logistic回归分析老年人社区医疗机构上门服务需要的影响因素。结果　22.83%（1 741/7 626）的老年人需要社区医疗机构的上门服务，在需要社区医疗机构上门服务的老年人群中，上门看病〔91.96%（1 601/1 741）〕是最需要的上门服务类型。不同出生队列老年人上门护理、上门看病、康复治疗的需要率比较，差异有统计学意义（P<0.05）。出生队列较早、农村地区、城中村社区的老年人更可能需要社区医疗机构上门服务（P<0.05）。Logistic回归分析显示，在1934年及以前出生队列中，性别、打算在哪养老、目前居住安排、拥有住房数量、居住地区、社区类型是上门服务需要与否的影响因素（P<0.1）；在1935—1944年出生队列中，自评健康状况、主要生活来源、居住地区、社区类型是上门服务需要与否的影响因素（P<0.1）；在1945—1954年出生队列中，性别、婚姻状况、受教育程度、自评健康状况、打算在哪养老、目前居住安排、社区类型是上门服务需要与否的影响因素（P<0.1）。结论　中国城乡老年人的社区医疗机构上门服务需要率较低，出生队列、生活环境、养老意愿和个体特质影响老年人的社区医疗机构上门服务需要。

关键词: 老年人, 社区卫生服务, 社区医疗机构, 上门服务, 上门看病, 上门护理, 康复治疗, 队列研究

TAN Wenjing,CHEN Gong. Needs of Home-based Health Services Delivered by Community Healthcare Institutions among China's Elderly People　[J]. Chinese General Practice, 2019, 22(25): 3041-3048. DOI: 10.12114/j.issn.1007-9572.2019.00.528.
谭文静,陈功. 中国老年人社区医疗机构上门服务需要研究[J]. 中国全科医学, 2019, 22(25): 3041-3048. DOI: 10.12114/j.issn.1007-9572.2019.00.528.

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