Survey And Analysis Of The Demand For Medical—Nursing Combined Service Among Elders And The Guarantee Of Community Resources In Chengdu

Objective1 ? To investigate the demand for Medical-Nursing Combined Service(MNCS)among elders in Chengdu and its influencing factors,in order to find a way to meet the needs of the Elders and improve them the quality of life.2 ? To explore the supply of Chengdu Community Health Resources(CHR)and analyze the problems in the supply process,in order to provide references for Rational allocation of community health resources and protect the elderly medical quality.3?From the perspective of the balance between the health resources supply and the elderly pension demand,analyze the difference,in order to provide a scientific basis to improve the medical policies and regulations,and puts forward some countermeasures and suggestions on the implementation and development of the MNCS in Chengdu.Methods1?Cross-sectional study: This is a descriptive study.Selected the elderly in Chengdu over 60 years old to conduct into this investigation by the method of convenience sampling.The principals of Community health service center and pension agency were conducted into this interview by the method of convenience sampling.The elders demand for MNCS were assessed by the questionnaire of“The Demand for MNCS Questionnaire ”,community health and pension resources supply situation was assessed by“Medical Institutions Questionnaire”,and “People interview topics”.2?Research object: Chengdu 60 years old and above the elderly,The principal of Community health service center or pension agency.3?Sample size: According to the "medical statistics " : the sample size is at least 5-20 times than the numbers of the variables.The study taken 15 times,and to determine the relevant research factors for 16.Taking into account the loss of the sample,so the sample size and then expand 25%,so the total effective sample of this study:(16 ×15)× 1.25=300(example).4?Data collection and statistics: All the data were input into Epidata3.1 to set up a database by double method,and SPSS21.0 statistical software was used for data analysis.Percentage,frequency were used to describe the Elders and Community Health Service Centers basic information,The demand score was described using mean,standard deviation;According to the data types,using Independent Sample t Test and Analysis of variance to analysis of different demographic characteristics of the elderly MNCS with the needs of pension services whether there is no difference;The Spearman rank correlation was used to analyze the correlation between the various factors and the needs of the elders;And step-wise multiple regression was utilized to analyze the main influential factors of elderly MNCS needs.Interviews data were collected using semi-structured interviews,after the interview,the data should be collated and analyzed in time.Results1?The total score of MNCS demand has been revealed(144.89±40.563),in a level of higher to moderate.According to the rank of mean score,the needs in detail as follows :public welfare(4.25±1.113),social participation(3.30±1.527),medical service(2.96±1.503),mental need(2.51±1.481),rights safeguard by law(2.39±1.375),and need for daily life care(2.28±1.470).2?The Univariate analysis showed the factors related to the demand for MNCS were include age,education level,marital status,living condition,mental state,health status,the number of chronic diseases,the elderly can bear the monthly pension service costs,a total of eight factors.3?According to the correlation analysis,the elders' age(r=0.226,P=0.000),the number of chronic diseases(r=0.245,P=0.000),the community can bear the monthly pension costs(r=0.272,P=0.000)were positively correlated with the MNCS,and cultural level(r=?0.118,P=0.040),health status(r= ?0.372,P=0.000),mental state(r= ?0.344,P=0.000)were negative correlated with the MNCS.4 ? Multivariate analysis showed that elderly person can bear the cost of pension services,health status,living conditions,mental state,education level were major factors affecting demand for the MNCS among elderly,which explained 27.9%.5?There were 829 health technicians,accounting for 88.85% of the total 933 employees in the 13 urban Community Health Service Center(CHSC).The ratio of health technicians to service population is 1: 1402,community doctor and service population ratio of 1: 3749,nurses and service population ratio of 1: 3330;less than 40 years of age health technicians 660;undergraduate and above 312 people,junior titles and the following 611 people.The training content includes professional skills,theoretical knowledge,professional accomplishment,professional development.The service projects include five categories: health care(76.49%),mental needs(10.36%),life care(5.98%),social participation(5.98%),legal aid(1.19%),and social welfare services To carry out.6 ? The main problems were include:poor communication between the community agencies,funding shortages,lack of staff allocation,publicity is not enough,equipment and facilities are not comprehensive and so on.Conclusion1 ? The influencing factors of the demand for the MNCS were existed in multidimensional.Monthly pension service costs,health status,living conditions,Mental state and educational level factors were affect the needs of the elderly MNCS.2?Health care combined with the pension service "Supply" "need" between the two sides there is an imbalance.Chengdu elderly people with a higher degree of demand for MNCS,and social welfare,social participation,health care needs higher.However,there are obvious "medical separation" and unreasonable allocation of resources in the supply of community health care services.Firstly,The services provided by the community are mainly based on health care services and life care services.Social services such as social welfare and social participation are not carried out or carried out at a high level and can not fully meet the needs of the elderly;Secondly,CHSC mainly provides basic medical and health services,other services to carry out less,or even not carried out,and pension agencies to provide life care services,other services rarely involved,the community "medical combination" to be further developed;Thirdly,Lack of professional staff and unreasonable allocation of equipment facilities and lack of funds,affecting the development of community MNCS.3?The main problems were include:unreasonable or shortcomings in human,financial and material resources,service content and opening a single way,lack of effective collaboration between management.4?Increase the policy support and publicity of MNCS,rationally allocate community health care resources,strengthen cooperation between departments and institutions is to further promote the development of MNCM an important way.