上海市老年人口峰值期预测

国际上通常认为,一个国家或地区65岁(或60岁)以上老年人口占总人口的比重超过7％(或10％),该地区即可被视为进入老年型社会.1978年,上海市65岁以上户籍老年人口占总人口比重达到7.3％,开始进入老年型社会.截至2009年底,上海市户籍老年人口数已达221.00万人,占户籍总人口的15.78％,已成为全国人口老龄化最严重的城市[1,2].研究并预测上海市人口老龄化的发展趋势,有助于系统地分析人口老龄化对就业、医疗及社会保障等各个方面的影响.深入分析上海市人口老龄化的发展趋势,就必须对上海市老年人口的发展趋势进行预测,尤其需要准确预测上海市老年人口的峰值期.     

上海市的老年医疗保健

人口老龄化是当今世界面临的共同问题。早在1979年,上海市60岁及以上的老年人口占总人口的比例已达10.2％,65岁及以上的人口已占7.15％。在全国率先成为老年型城市。 1982年第三次人口普查时,60岁及以上和65岁及以上的老年人口占总人口的比例依次为11.54％和7.43％;1990年第四次人口普查时,已分别上升到14.06％和9.24％;预测到2000年,上海市老年人口将分别上升列16.16％和12.28％。根据至1992年底的估算,60岁及以上老年人口达205万,约占总人口的16％。在本世纪末,上海市老年人     

中国老年人医疗费用的负担水平及变化趋势

目的 探讨中国老年人医疗费用负担水平及变动趋势.方法 运用“中国城乡老年人口状况一次性调查”2000年和2006年两次调查的数据,选取相关指标,对老年人的医疗费用负担的水平及变化趋势进行描述和比较分析.结果 男性老年人医疗费用负担水平高于女性;城市老年人医疗费用负担水平高于农村老年人;受教育程度提高,老年人的医疗费用负担水平增高;收入水平提高,老年人的医疗费用负担水平增高.结论 不同人口和社会特征的老年人的医疗费用分布呈现一定的规律性.两次调查间,老年人的医疗费用的上涨速度非常快.     

中国应对人口老龄化的对策

<正>1面对人口老龄化现状,我国的严峻挑战1.1在老年人收入方面全国老龄委调查显示〔1〕,城市老年人年平均收入从2000年的7 392元提高到2006年11 963元,增长了61.8%,同期老年人年收入低于当地最低生活保障线的比例由4.9%下降到3.5%,享受退休金(养老金)的比例由69.1%上升到78.0%;农村老年人年平均收入同期从1 651元提高到2 970元,增长了79.9%。据2000年中国城乡老年人口状况一次性抽样调查和2006年中国城乡老年人口状况追踪调     

澳大利亚老年公民医疗福利保健网络

澳大利亚的人口老龄化问题相当严重。1986年维多利亚州人口平均寿命达到男性76岁,女性78岁,65岁以上老人占人口的14％。在300万人口的墨尔本市,65岁以上老人就约有42万之多。人口的老化对仅有1600万人口的澳洲来讲是一个不容忽视的社会问题。战后澳洲政府对此进行了多次决策讨论,除制定法律鼓励生育,增加移民,以改变人口结构比例外,还对老年公民的社会福利、医疗保健和康复服务等作出了多项规定。也由于经济繁荣,使澳洲有可能在全国范围内建成条件完善的老年医疗福利保健网络,设立一整套适合澳洲国情的老年医疗康复制度,保证老人能安度晚年。老年人的保健网实质上是一项医疗和社     

西安市老年人卫生服务需求及变化的研究

为适应老年人口日益增加这一变化趋势,适时调整卫生服务方式及合理配置卫生资源,笔者于1991年10～11月对西安市老年人进行抽样调查,并结合1986年的调查结果,研究老年人卫生服务需求的变化。 1 对象及方法 依据1986年西安市城区患病率分层抽样,得5个街道办事处,从每个街道办事处中随机抽取1个居委会,对60岁及以上老人进行访谈调查。调查由卫生管理专科及卫生专业本科学员配合完成,资料     

盐城市郊区老年人住院情况分析

随着社会的老年化,老年人口逐年增加。为了进一步做好老年人医疗保健工作,笔者对盐城市郊区1984～1986年三年间老年人住院情况进行了一次调查分析。     

重庆三峡库区老年人口社区卫生服务利用与满意情况调查

目的 了解重庆三峡库区老年人口社区卫生服务利用现状与满意情况.方法 采用多阶段抽样方法抽取重庆三峡库区688名60岁以上老年人进行社区卫生服务利用与满意状况的入户调查.结果 虽然有大部分的库区老年人(45.1%)主要由于就近方便(55.6%)等原因而选择社区卫生服务机构就诊,但这一就诊比例仍然较低.并且库区老年人对社区卫生服务的内容缺乏了解,影响卫生服务的利用.还有相当大部分的库区老年人对社区卫生服务并不满意,主要原因是医疗收费、技术水平与环境设备方面还存在问题.结论 社区卫生服务机构应该联合社区资源,增加老年人对社区卫生服务内容的了解,并且采取各种措施,提高老年人口的满意度.     

上海市区老年体协会员体育活动情况的抽样调查

迄1986年末,上海市区60岁以上老年人101.84万,占全市老年人口总数的61.67％,市区老年体协60岁以上会员24616人。1987年6月,我们在各级老年体协的支持配合下,根据该会1986年统计数,按人、项等额分配,照基数2％随机抽样,实抽520份,调查问卷由被调查者自填,回收508份,废卷10份,有效回收率95.77％,结果报道如下。     

上海市金山石化地区老年人急诊伤害流行病学调查

目的研究上海市金山石化地区老年人口急诊伤害的流行病学特征。方法采用描述性流行病学方法调查上海市金山石化地区老年人口2012年11月1日至2013年10月31日急诊伤害就诊情况。结果老年人口急诊伤害占急诊总量的1.92%,病死率0.37%。老年人口伤害死亡占急诊总死亡构成的5.0%。结论上海市金山石化地区老年人口急诊伤害构成比高,病死率高。加强老年人群伤害预防和建立完善的老年人口伤害检测系统非常重要,应采取综合性措施预防老年人急诊伤害。     

The relation between unpaid support and the use of formal health services: the Sydney Older Persons Study

Objectives: To examine the inter‐relationships between formal and informal unpaid services in an elderly population. Methods: 537 community‐dwelling elderly (75 or older) were interviewed about use of community and medical services and the provision of unpaid support. Disease and disability were assessed by medical practitioners. The relationship between service use and unpaid support among persons with the same disease/disability profile was examined. Results: Unpaid network support for instrumental activities of daily living (IADL) needs was utilised when community services were not. Unpaid ADL and IADL network support is used in conjunction with medical services. Higher socioeconomic status, female gender and having fewer coresidents predicted higher use of community services. Males spent more days in hospital. Conclusions: Community IADL services and unpaid IADL network support work in a compensatory fashion. In contrast, higher users of medical services were greater users of unpaid network support.     

Internal medicine in the National Resident Matching Program 1987: the ides of March

The number and percentage of graduating seniors from medical schools in the United States who have matched to categorical programs in internal medicine in the National Resident Matching Program have decreased since 1985. Examination of the balance between undergraduate and graduate medical education in the 127 networks of each medical school in the United States and its associated hospitals showed major differences in the retention and recruitment of graduates. The service needs of hospitals rather than the number of graduates from schools in the United States would seem to have controlled the number of positions. Because the positions exceeding the number of graduates from the United States are filled by graduates of foreign schools, these positions are of major importance in determining the supply of internists. The clerkship programs must be restructured to provide students an improved introduction to internal medicine, and the number of entering positions in residencies must be reduced by the substitution of other personnel to do some of the service functions now done by residents.     

Geriatric home health care. Conceptual and demographic considerations.

This article has explored conceptual and demographic aspects of HHC and the distinction between formal and informal care. HHC for elderly persons is shown to be mainly an informal, familial activity with important formal professional, skilled, and unskilled components. Formal home health care in the United States has undergone a historic transformation with the rise of third-party payment as a principal, defining force and with demographic and epidemiologic transition of the general population. Recent national studies demonstrate that the principal population group receiving HHC services--the chronically ill, functionally limited, noninstitutionalized elderly--is growing in number and as a proportion of the group with home and community service needs. Although diverse formal service innovations are being explored to meet these growing needs, current involvement of medical professionals in formal HHC emphasizes relatively short-term, post-acute therapeutic and restorative care offered through Medicare-certified home health agencies.     

Projection of death rates from ischemic heart disease in Japan, 1985-2000

Death rates from all forms of ischemic heart disease and acute myocardial infarction were projected between 1985 and 2000 A.D., based on vital statistics from 1973 to 1982 and the estimated population by sex and age groups in Japan. It is predicted that the crude death rate from ischemic heart disease will increase (+1.4% per year for males and +1.8% for females), and that the age-adjusted death rate will decrease (-1.1% per year for males and -1.4% for females). The crude death rate from acute myocardial infarction is predicted to increase steadily (+2.4% per year for males and +2.2% for females), though the age-adjusted rate will decline slightly (-0.5% per year for males and -1.0% for females) throughout this period. The crude death rate from acute myocardial infarction is predicted to increase more than the rate from ischemic heart disease. It is estimated that the total number of deaths will increase from 48,000 (males and females combined) in 1982 to 72,000 in 2000 for ischemic heart disease, and from 29,600 in 1982 to 45,500 in 2000 for acute myocardial infarction.     

Clinical aspects of pneumonia in the elderly veteran

While atypical presentation of pneumonia in elderly patients is thought to be common, its incidence and factors predisposing to it are unknown. This study documents presenting symptoms of pneumonia in 48 patients, aged 65 or older, admitted to the medical service at a Veterans Administration Medical Center. Seventeen subjects (35%) had a classic constellation of symptoms which included both fever and cough. A chief complaint suggestive of pneumonia, defined as cough, fever, or shortness of breath, occurred in 27 subjects (56%). Five subjects (10%) had no symptoms suggestive of pneumonia even with a detailed history. Absence of a classic constellation of pneumonia symptoms correlated with advanced age (P = .0045), cognitive impairment at admission (P = .022), and baseline functional impairment (P = .028). Neither nutritional status as measured by serum albumin nor medical status as measured by number of medical problems and number of medications predicted an atypical presentation of pneumonia. Nineteen subjects (39%) did not have a documented fever, and 15 subjects (31%) did not have a leukocytosis. Absence of fever or leukocytosis did not correlate with age, number of medical problems, number of medications, cognitive status, functional status, or serum albumin. We conclude that a classic constellation of symptoms, signs and laboratory findings is frequently absent but some suggestive symptom is usually present in this population of elderly veterans with community-acquired pneumonia. Patients with advanced age, cognitive impairment at admission, and baseline functional impairment are most likely to have an atypical presentation of pneumonia.     

Recreational Travel and the Elderly: Marketing Strategies with a Normalization Perpective

Research suggests that elderly travelers may differ from other travel segments of the population. A desired approach toward service provision is based on meeting individual needs and interests of the elderly traveler, but avoids stressing "differentness" as much as possible. A marketing mix directed toward this population, including the product, place, price, and promotion associated with the travel service, enables the director to successfully meet the travel needs and interests of the elderly. Travel directors must also work to ensure that travel experiences are appropriate and meaningful, stressing respect and dignity for the elderly.     

Geriatric assessment in the elderly cancer patient

Lost and remaining functions are of special importance in geriatric medicine. The level of functional deficits ultimately determines the remaining quality of life and the patient's ability to continue independently. In contrast, the actual severity of a disease measured by common standards becomes less important. Geriatric assessment is increasingly used to describe the impact of disease and to focus on the functional losses and problems that are particularly relevant to the individual elderly patient. When developing a treatment plan for older cancer patients, it is essential to consider the functional deficits caused by age-related changes or comorbidity, the remaining compensation mechanisms and the patient's expectations. Cancer treatment has to be adapted to the individual needs of elderly patients. As the number of cancer patients is rising in all areas of medical practice, a close collaboration between oncologists and geriatricians will become increasingly important. Received: 12 January 2000 / Accepted: 25 January 2000     

医养结合型养老院糖尿病人的护理与健康教育研究

我国目前老年人群的特点有:老龄人口数量多、老龄化速度过快、空巢老人数量多、患病率高以及社会相关的养老保障措施不够完善等。基于这样的社会大环境之下,我国对于老年人群的养老保障措施以及护理康复服务越来越重视,医养结合的模式也应时而生并且还在进行着不断的发展与完善。由于老龄人群日益显著的问题,养老服务机构的转型以及各种资源的整合已经是大势所趋。由于人们的生活方式和饮食结构的巨变以及与日俱增的生活压力等种种因素致使我们如今越来越多的人患上了糖尿病,糖尿病的发病率居高不下。为了推动医养结合型护理模式发展以及对于老年糖尿病患者相关的护理与健康指导的进步改善,该文分析目前医养结合型护理模式以及对于老年糖尿病患者的护理,希望能为医养结合型的养老院糖尿病人的护理工作提供具有价值的参考。     

Palliative Access Through Care at Home: Experiences with an Urban, Geriatric Home Palliative Care Program

The aging of the U.S. population has resulted in a large number of persons with multiple, chronic illnesses and gradual functional decline. Many older adults with these conditions are homebound and have great difficulty accessing medical care. They are also more likely to suffer from unaddressed symptoms and end-of-life care needs. Certain groups, such as African-American patients and patients with dementia, are even less likely to access palliative care and hospice services. Although the informal caregivers attending to such persons may become overwhelmed without adequate support, palliative care, which covers a broad population, is an optimal way to address many of these needs. This article describes a unique, urban, home-based geriatrics palliative care program (Palliative Access Through Care at Home (PATCH)) designed to address some of these unmet needs. After 1 year of providing service, a mixed-methods study consisting of chart review, telephone interviews, and face-to-face interviews was conducted to assess caregiver expectations of and satisfaction with the program. Caregivers for the elderly, mostly African-American patients, more than half of whom had dementia, were overall very satisfied with their experience, despite the large amount of time necessary to provide the care that patients required. Themes extracted during qualitative analysis were the desire to remain at home, the need for easy access to a practitioner specializing in geriatrics and palliative medicine, and the challenges of transitions of care. PATCH was able to address many of these needs and provide high levels of caregiver satisfaction.