Study On Evaluation Of The Effect About Community Health Management On The Elderly

Objective To improve and optimize the constructed evaluation system, and manage to construct a health related index evaluation system including physical health, psychological health, social adaptation abilities and health behavior. Applying analytic hierarchy process (AHP) and Bayesian method to obtain the weight systems and comparing the differences between them. The aim of this paper is to evaluate the health related conditions and get a full picture of the health status of the elderly, and provide some guidance at pension, medical and social support of China’s elderly population, thus contributing to achieve healthy aging.Methods Making a two rounds expert consultation using Delphi method in order to construct health related index evaluation system of the elderly. Evaluating the validity and reliability of the index system with correlation analysis, factor analysis and reliability coefficient. Using Analytic Hierarchy Process and the modified AHP with Bayesian method determined the dimensions and the weights of indicators. Cluster sampling was selected to investigate and collect baseline information of those who are aged over 60 in the community of Nanjing. Those who were selected was divided into hypertension group, diabetes group and general group according their actual health status, and divided into management group and control group randomly. Management group was accepted 18-month health management, including contributing health manual, developing health lectures and behavioral intervention. The revisit was launched at the end of health management. Health score was evaluated by chi-square test,t test,variance analysis and non-parametric test. Fussy comprehensive evaluation, multiple linear regressions were used to evaluate the health status of the elderly population and discussed the main factors affecting their health.Results 1.The health related index evaluation system comprises 6 dimensions and 47 indicators, and the means of importance, sensitivity and feasibility are 8.12±1.02, 8.16±0.960.12 and 7.88±0.91, and their coefficient of variance are0.12,0.13 and 0.12.2. The results of the AHP weight coefficients and the modified AHP with Bayesian method weight coefficients in this paper are basically the same. The AHP is a subjective method which results is difficult interpreted, while the modified AHP with Bayesian method is more reasonable.3. After 18 months of health care, there are 22 indicators in hypertension group and general group,14 indicators in diabetes group were improved, and the effective size of those indicators were from 0.289 to 1.104, attributing to medium to large management effect.4. The results of Fussy Comprehensive Evaluation show that Health management has a good effect on the health of the elderly, but health behavior and social adaptation ability has not been well maintained.The management effect of hypertension group was the best, and the diabetic population was the second.5. The results of multiple linear regression show that scores of different dimension influenced by different factors.Gender influence the scores of physiological function and ADL&IADL,and female tend to receive better results.Age influence the scores of physiological function,ADL&IADL,memory function and integrated health,and as the growth of the age, the scores tend to be lower.The scores of ADL&IADL,social adaptation ability,health behavior and integrated health are proportional to the degree of education.The scores of memory function and social adaptation ability are related to marital status.Living situation influence the scores of emotion&character and memory function,and those who living with family members get higher scores.Conclusion The elderly health assessment scale has a good reliability and validity, the health evaluation indicators system can reflect the health status of older people accurately. Health care is useful for most indicators, and health care can enhance the subordinates’ self-discipline consciousness and the sense of self responsibility,but management effect is not proportional to management cycle, and different people has different health claims, thus individualized health care measures are formulated. The reform of endowment insurance and medical insurance, the development and growth of the health service group and perfecting the community health management mode are the necessary measures to develop health care.