Study On The Establishment And Application Of The Evaluation Index System Of Community Aged Care Service Demands

Objective:The evaluation of community aged care service demands is the key link to construct and perfect the aged service system.This study aimed to explore and develop a suitable evaluation index system of community aged care service demands in China,and to evaluate the demands for community aged care services by using the index system.Methods:First of all,on the basis of Maslow's hierarchy of needs theory and Orem's self-care theory,the Delphi method was used to prelimitnarily construct the evaluation index system of community aged care service demands.Secondly,in the 2014 Chinese Longitudinal Healthy Longevity Survey(CLHLS)database,1684 training samples and 5052 examination samples were randomly selected from the elderly aged 65 and over who lived in the community in accordance with the ratio of 1:3.The correlation coefficient,Cronbach coefficient and exploratory factor analysis were used to filter the index for every dimension on the training samples.Then,the exploratory factor analysis was used to filter the index for the whole dimension.Furthermore,Cronbach coefficient and confirmatory factor analysis were applied to test the reliability and validity of the index system by examination samples.Finally,descriptive statistical analysis and independent-samples t test were used to analyze the current situation of demands for community aged care services in China.Results:A total of 15 valid expert consultation tables were collected from 20 experts in universities,institutions for the aged and hospitals in this study.The coefficient of authority of experts was above 0.78,and the Kendall coefficient of index importance and operability score was between 0.165 and 0.234,all of which were statistically significant.An index system consisting of 7 first-level indicators,18 second-level indicators and 44 third-level indicators has been preliminarily constructed with equal weight of indicators at all levels.By constant filtering and optimization,a total of seven first-level indicators,14 secondary indicators,32 tertiary indicators,including self-care ability(ability of daily life(ADL),physical health,mental health,cognitive function),care resources(social relations,economic resources)and service expcctalion of community aged care services were formed.The evaluation of the index systcem showed that the overall Cronbach coefficient was 0.809,KMO value was 0.865,Bartlett's spherical test P<0.001,confirmatory factor analysis RMR was 0.076.,GFI,AGFI,IFI and CFI were 0.923,0.909,0.905 and 0.905,RMSEA was 0.049,respectively.On the whole,the total score of the demands f'or community aged care services in rural areas(2.89±0.63)was hiIgher than that in urban areas(2.77±0.67),and they strongly expected for more aged care services.To be specific,the self-care ability,including ADL,physical health,psychological health and cogIgnitive function of elderly women was obviously weaker than those of elderly men(P<0.001),while the number of years of education was negatively correlated with self-care ability(P<0.001).Women,senior citizens and those with less years of education needed more social relationship resources(P<0.001).Older people with more years of education had less demand for economic resources.From high to low,the elderly had high expectations of medical care(0.8G±0.31),preventive health care(0,82±0.34),spiritual comfort(0.71±0.3 8),legal aid(0,68±0.39)and life care services(0.66±0.39),among which the elderly with advanced age(P<0.020)and low years of education(P<0.001)had particularly high expectations of medical care services.In rural areas,men(P=0.020),middle and young aged people(P=0.014)had higher expectations for legal aid,and middle and young aged people(P=0.037)also had high expectations for preventive health care services.Conclusion:The evaluation index system of community aged care service demands in this study,got a positively feedback from experts,and all the test indicators were good.The content of aged care service demands in China is diverse,and the needs of different groups are significantly different,among which,the advanced aged residents with low years of education have the greatest demand for medical care services.Therefore,based on the evaluation index system of community aged care service demands obtained in this study,a standardized evaluation of community aged care service demands can be formed to meet the diversified needs of the elderly.