山东省临沂市城区、农村医养结合机构老年人养老就医现状对比分析

目的调查临沂市城区和农村医养结合机构中老年人接受养老、就医服务的现状,对比分析城乡差异。方法随机抽取山东省临沂市城区和农村医养结合机构各1个,采用自制调查问卷对机构中171例老年人的个人基本情况、身体健康状况、养老就医服务需求现状进行调查分析。结果本次调查的171例老年人,以女性(57.9%)、80岁及以上(43.3%)、丧偶/离异(58.5%)、文盲(71.3%)、农民(80.1%)、月收入1000~2900元者(46.8%)为主。绝大部分老年人都患有慢性疾病(76.6%),在承受重大疾病方面存在一定困难(80.1%)。基本情况比较,农村的医养结合机构的老年人年龄相对较小、女性较多、文化程度较低、农民为主、收入方面两极分化严重(P均<0.05);城区医养结合机构的老年人独居者较多(P<0.05)。身体健康状况比较,城区医养结合机构的老年人对自身健康状况评价一般或较差,而农村医养结合机构的老年人普遍认为自己健康水平一般(P<0.05)。养老就医服务需求方面比较,农村医养结合机构的老年人就医更偏向于选择一级医院、承受重大疾病能力更差、医保类型更倚重居民医保、医保结合付费更低、获得家人支持的比例更低、照料来源更倾向于配偶和子女(P均<0.05)。结论山东省临沂市城区和农村医养结合机构中绝大部分老年人都患有慢性疾病,在承受重大疾病方面存在一定困难。农村的老年人承受重大疾病能力更差、获得家人支持更低、收入方面存在两极分化,各地发展养老服务时应统筹城乡差异,注重城乡一体、服务共享、分类指导、统筹建设,从而满足老年人的养老需求。

Comparative analysis of the status of the elderly in the medical and nursing institutions in the urban and rural areas of Linyi City,Shandong Province

Objective To investigate the status of receiving pension and medical services of elderly people in both urban and rural medical and nursing institutions in Linyi City,to compare and analyze the differences between urban and rural areas.Methods Randomly select one medical and nursing institutions in urban and rural of Linyi City,Shandong Province,and use a self-made questionnaire to investigate and analyze the personal basic information,physical health sta⁃tus and the status of receiving pension and medical services of 171 elderly people in the two institutions.Results The 171 elderly people were mainly female(57.9%),80 years old and above(43.3%),widowed/divorced(58.5%),illiter⁃ate(71.3%),farmer(80.1%),and monthly income between 1000 and 2900 yuan(46.8%).Most of the elderly suffer from chronic diseases(76.6%)and have some difficulty in bearing major diseases(80.1%).In terms of basic informa⁃tion,the elderly in rural medical and nursing institutions were relatively younger,more female,less educated,more farm⁃ers,and polarization on income(P<0.05).There were more elderly people living alone in medical and nursing institu⁃tions in urban areas(P<0.05).In terms of physical health status,the elderly in urban medical and nursing institutions be⁃lieved their health status was average or poor,while the elderly in rural medical and nursing institutions generally rated their health status as average(P<0.05).In terms of pension and medical services for the aged,the elderly in rural medi⁃cal and nursing institutions tend to choose first-level hospitals,have worse ability to withstand major diseases,rely more on NRCMS for medical insurance,pay less for medical insurance,have lower proportion of family support,and prefer spouse and children for care(all P<0.05).Conclusions In Linyi City,Shandong Province,most of the elderly in urban and rural medical and nursing institutions suffer from chronic diseases and have some difficulties in bearing serious diseases.The elderly in rural areas have worse ability to bear major diseases,got lower support,and shown as polarization on in⁃come.In the development of old-age services in various areas,urban and rural differences should be considered.Focusing on the integration of urban and rural areas,service sharing,classified guidance,and overall construction should be insist,so as to meet the needs of the elderly.