| Objective:Case Study on Changchun,investigate the status quo of the elderly health care services in community health services,and the status quo of old-age care related attitudes,quality of life;Then learn about the needs of health care services for the elderly in the home,analyzes the influencing factors;Combined with domestic and international factors.Advanced experience and related theoretical frameworks to build a healthy home-supporting care model based on community health services.Methods:Using stratified sampling and quota sampling,240 elderly home residents living in the service areas of 8 community health services in Changchun City as the research object.From January to September,2017,questionnaire survey was conducted on eligible elderly people at home.The survey tools included questionnaires for general information,questionnaires for aged health care services for community health services,questionnaires for attitudes towards elderly care for the elderly at home,and SF-36.Scales and survey questionnaires on the needs of elderly home health care services.The data was double input using Epidata 3.1,and SPSS 21.0 was used for statistical analysis of data:general information,current status of elderly health care services in community health services,and home-related attitudes,quality of life,and health care needs of the elderly in the home is expressed in terms of frequency,percentage,mean±SE,median and quartile.The influencing factors of the aged people's aged people's health care needsc~2 test,t test or non-parametric test;Logistic regression analysis is used to analyze the influence relationship between various factors,established a high demand forecasting model of home aged people's healthy pension,then ROC curve is used to evaluate the model;Use chi-squared automatic interaction detector(CHAID)to deepen data mining.Results:1.The self-made“Study Scale for the Aged People's Health Aging Service Requirements”includes 4 dimensions,27 items.Cronbach's alpha of 0.948,a Guttman Split-Half coefficient of 0.828,a KMO of 0.901,and a Guttman Split-Half of 5931.881,indicating that the reliability and validity of the scale are good.2.The effective sample size was 229,and the average age was(69.56±7.15)years.Most elderly people chose to live with their spouse or live alone.Only 40(17.5%)of them lived with their children.3.The elderly health care service in community health services is well under way.More than 50%of the elderly living in the home have signed up with community family doctors;the elderly are positive about the activities carried out by community health services,and only 14.9%of the elderly people are reluctant to participate in the above activities.And the elderly are relatively satisfied with the service attitudes,traffic conditions,distances,and medical-related costs incurred by the community health services.4.79.9%of the elderly in the home expect to continue to provide for the elderly in their homes,and their diversity of help in life is expected,such as daytime company and love hotline(telephone,Internet,etc.)(41.1%),and economic/living material support(28.4%).In addition,home services(20.1%)are on-site services;expectation is that there are also a large number of elderly care providers.Most elderly people expect that medical professionals,dietitians,psychotherapists and other professionals will provide aged care services.5.The quality of life of the elderly at home is relatively low,with a total average score of(61.38±18.18)points,and the difference between the dimensions is large.Among them,the emotional function dimension(M=33.33 points)scored the lowest,followed by the general health status dimension(M=45.00 points)and the physiological function dimension(M=50.00 points).6.The final independent influence factors of the demand for health care services for the elderly at home are:total personal monthly income,major expenditures other than life,at least one specialized health promotion physician/family doctor in community health services,and community health satisfaction of services attitudes,satisfaction of medical expenses personally borne by community health services,willingness to purchase care insurance,and total quality of life.7.High demand for aged aged people's health care services=exp{[1.133*the Service Attitude Satisfaction of the Community Health Services]+[0.665*Satisfaction with Medical Expenses Paid by Community Health Services]+[1.162*Willingness to Purchase Nursing Care Insurance(Yes=1,No=0)]-[0.033*Total Quality of Life Equivalently-6.455}.Evaluation of the prediction results showed that the area under the ROC curve was 0.831,95%CI(0.779~0.884,P<0.0 0 1),th e s en s iti v i t y w as 7 5.0%,and t h e s p eci fi ci t y wa s 7 8.6%.9.The interactive factors affecting the degree of health care needs of older people in the home include:satisfaction with the service attitude of community health services institutions,expecting old-age care,physiological functions,willingness to purchase long-term care insurance,willingness to participate in community activities organized by community health services personnel,and satisfaction with traffic and distance of community health services.10.Based on the results of ChangChun research,combining domestic and foreign excellent experiences and related theoretical frameworks,a healthy home-based care service model based on community health services was constructed,and elaborated on the three major aspects of the construction principles,basic framework,and safeguard measures.Conclusions:1.The elderly health care service in community health services is well developed,and the evaluation satisfaction is high.Home-based care for the elderly is the main expectation of old-age care,the diversity of help they expect in their lives is diversified,the expectation is that elderly care providers are also diverse,and the quality of life of the elderly is low.2.There is a high level of demand for health care services for elderly people in the home,especially for medical and health care.It is also affected by many factors,and there are interactions among various influencing factors.3.Based on the results of field research,a healthy home-supporting care model based on community health services provides suggestions and countermeasures for promoting healthy aging. |
PDF Full Text Request