Analysis On The Choice Preference And Influencing Factors Of Long-Term Care Model Of The Elderly In Shandong Province

Objective:To investigate the elderly's preference to Long-Term Care Models:family care,home care in communities(HCC)and institutional care in Shandong Province.Then we compared the preference of the elderly in long-term care models of the elderly in Shandong Province basing on the Anderson's'behavioral theory,and put forward the social measures to better allocate endowment resources.The other purpose is to provide an important theoretical basis for relevant departments in Shandong province to formulate sound,reasonable and long-term old-age care policies,so as to improve the health level and quality of life of the elderly.Methods:Stratified multi-stage random sampling was applied(The specific methods are detailed in Chapter 3).6997 elderly people aged 60 years and over in Shandong Province were selected as subjects of study.The survey tools classified according to Anderson's theoretical model include predisposing characteristics(gender?age?education?occupational situation?living arrangement?marital status)?Enabling factors(residence?regional distribution?annual income?health insurance)and Need factors(Chronic diseases?ADL?Self-rated health?The Satisfaction with life Scale?10-item Kessler Psychological Distress Scale?University of California Los Angeles Loneliness Scale).The data are analyzed by SPSS21.0.The statistical methods include descriptive statistical analysis.Chi-square tests.Kruskal-Wallis,Multinomial Logistic regression analysis.Result:1.General information of the participatesA total of 7078 questionnaires were distributed in this study.After eliminating the invalid questionnaires,6997 elderly people were included in this study.In terms of gender,females(59.6%),30.0%aged between 65 and 69,41.3%of primary school students.48.6%of them are unemployed,and 33.8%of them are empty nest/solitary.The annual income of the elderly is grouped according to the quartile method.The annual income of the elderly is less than 3000 yuan,accounting for 27.6%;the residents have the most medical insurance methods,accounting for 79.4%;the rural elderly account for 70.9%,and the eastern,central and western regions are relatively uniform.The elderly with chronic diseases accounted for 64.3%.the elderly with a chronic disease accounted for 40.9%;the elderly with normal daily living activities accounted for 77.2%;the self-rated health status was "good" accounted for 53.4%;the loneliness score was 8.05±3.65,the psychological stress score was 15.34±6.68,and the life satisfaction score was 30.73±4.99.2.Preference to choose Long-Term Care Model with single factor analysisThe elderly in Shandong Province choose family care.HCC and institutional care,which are 89.1%,2.7%and 8.2%respectively.Chi-square test results showed that there were significant differences among gender,age,education level,current employment status,income,medical insurance mode,residence,regional distribution and ADL on the choice of pension mode(p<0.05);Kruskal-Wallis results showed that loneliness and psychological stress had significant differences on the choice of Long-term care models(P<0.001).3.Multinomial Logistic regression analysis of the preference on long-term care modelsFitting degree of three Multinomial logistic regression models showed that the value of-2LL and determination coefficient R2 of Model ?-? increased gradually.In Model I,there were significant differences in the choice of "farmily and HCC" and"family and institution" care modes among the different gender,age,education level and current employment status.In Model ?,there were significant differences in the"family and HCC" pension modes in model I,and there were significant differences in gender,age and current employment status in the "family and institution "pension modes.Among the newly introduced variables,there are statistical differences in the"family and HCC" pension mode.Residence and regional distribution exist in the selection of "family and institution" pension mode.In Model ?,the predisposing factors and enabling factors are the same as the result of model ?,but there are significant differences in the annual income in the choice of "family and institution"pension mode.Among the newly introduced variables,ADL grade and loneliness have significant differences in the choice of "family and HCC" pension mode.Loneliness and psychological pressure have significant differences in the choice of "family and institution" pension mode.Conclusion:1.Among the three Long-term care models,family care is the preferred mode for the elderly in Shandong Province.The government should strengthen the supporting role of "family pension";at the same time,it should construct a pension service pattern in line with the conditions of Shandong Province.2.The younger age group with higher education tend to choose the socialized Long-Term Care Model.With the intergenerational change,the demand for the socialized Long-Term Care Model of the elderly in Shandong Province may increase.It is necessary to speed up the infrastructure construction of community homes and pension institutions and the professional training of nursing talents and the industrialization of nursing.3.Economic factor is one of the important factors that restrict the old people's choice of socialized pension model.Besides strengthening and improving the social pension security system,we can learn from the long-term care insurance system of developed countries and pilot cities in China.There are significant differences in the old people's choice of pension mode between eastern and Western regions,and we can carry out regional planning for the old age.4.When the self-care ability of the elderly decreases and their loneliness becomes stronger,they tend to seek the help of HCC or institutional pension model.While strengthening the construction of social pension services,they should pay attention to the physical and psychological needs of the elderly,so as to meet the needs of the elderly to return to society or the collective.