摘要
目的:分析长护险受益人的共病现状及服务模式选择的影响因素,为长护险制度优化提供建议。方法:以湖北省J市60岁及以上的长护险受益人共4374人为研究对象,运用描述性统计、单因素分析及二分类Logistic回归分析长护服务模式选择的影响因素。结果:样本人群平均年龄79.43±9.72岁,平均失能评分20.23±12.67分,共病率为55.01%,修正Charlson共病指数5.93±1.39分;患病率最高的两类疾病为脑卒中(54.09%)和高血压(50.78%),89.73%的样本人群选择居家护理,高龄、重度失能、有家属照护、有职工医保的老年人更倾向于选择机构护理;地区也是长护服务模式选择的影响因素之一。结论:重视老年人共病管理,推动慢性病管理的优化升级,为高龄、重度失能老年人提供专业护理服务,减轻家庭照护负担,对居家护理服务采取合理监管手段,促进长护服务职业化发展。
Objective To analyze the comorbidity status of long-term care insurance beneficiaries and the influencing factors of service model selection,and to provide suggestions for the optimization of long-term care insurance system.Methods A total of 4 374 long-term care insurance beneficiaries aged 60 and above in J City,Hubei Province were selected as the research objects.Descriptive statistics,univariate analysis and binary logistic regression were used to analyze the influencing factors of long-term care service model selection.Results The average age of the sample population was 79.43±9.72 years old,the average disability score was 20.23±12.67 points,the comorbidity rate was 55.01%,and the modified Charlson comorbidity index was 5.93 ±1.39 points,the two types of diseases with the highest prevalence were stroke(54.09 %) and hypertension(50.78%).About 89.73% of the sample population chose home care,and the elderly,severely disabled,with family care and employee medical insurance were more inclined to choose institutional care.Region was also one of the influencing factors of the choice of long-term care service model.Conclusion It is suggested to pay attention to the management of comorbidities in the elderly,promote the optimization and upgrading of chronic disease management,provide professional nursing services for the elderly and severely disabled elderly,reduce the burden of family care,adopt reasonable supervision methods for home nursing services,and promote the professional development of long-term nursing services.
作者
王思彤
陈晓晨
朱学敏
杨君婷
刘跃华
WANG Sitong;CHEN Xiaochen;ZHU Xuemin;YANG Junting;LIU Yuehua(Institute for hospital management,Tsinghua University,Shenzhen Guangdong 518057,China;不详)
基金
2019年国家自然科学基金青年项目(71804032)
泰康溢彩公卫专项基金“中国失能老年人医养结合整合照料模式与支付标准研究”。
关键词
长期护理保险
老年人
共病率
服务模式选择
long-term care insurance
the elderly
comorbidity rate
choice of service mode
