我国老年人社区居家养老服务利用情况的影响因素研究

目的 分析我国老年人社区居家养老服务利用情况的影响因素。方法 选取2018年中国健康与养老追踪调查数据(CHARLS)中重要变量完整的17 075名老年人，收集人口社会学特征、生活方式、养老服务利用等信息。根据社区居家养老服务利用情况分为利用组（1 946人）和未利用组（15 129人）。按1∶1对人口学特征行倾向性评分匹配，并采用logistic回归分析社区居家养老服务利用的影响因素。结果 成功匹配1 945对，匹配前两组数据在年龄、教育水平、婚姻状态的组间差异有统计学意义(t=42.560，χ¹=126.614，191.320，P<0.001)，匹配后在人口学特征上的组间差异均无统计学意义(P>0.05)。多因素logistic回归分析模型结果显示，戒烟(OR=1.168，95%CI:1.008~1.396)、患慢性病(1~2类，OR=1.433，95%CI:1.107~1.687；≥3类，OR=1.566，95%CI:1.269~1.931)、无社会活动量(OR=0.617，95%CI:0.515~0.741)、无长期照顾者(OR=0.573，95%CI:0.496~0.661)、有养老金或退休金(OR=1.221，95%CI:1.034~1.443)及医疗服务满意度(一般，OR=1.375，95%CI:1.127~1.678；满意，OR=1.531，95%CI:1.257~1.865)是老年人社区居家养老服务利用的独立影响因素(P均<0.05)。结论 倡导健康的生活方式、加强健康管理、鼓励社会活动、加强长期照护和提高社区医疗服务水平可有效促进我国老年人对社区居家养老服务的利用。

The influencing factors of the utilization of community home-basedcare services for the elderly in China

Objective To analyze the influencing factors of community home-based care service utilization among the elderly in China. Methods A total of 17 075 elderly people with complete important variables in 2018 China Health and Retirement Longitudinal Study(CHARLS)database were selected, and their information of basic demographic, lifestyle, and the utilization of community home-based services were collected. According to the status of utilization of community home-based services, the elderly people were divided into the used group(number=1 946) and the unused group (number=15 129). The demographic characteristics were matched with propensity score matching with 1:1, and logistic regression was used to explore the influencing factors of community home-based care services. Results A total of 1 945 pairs were matched successfully. There were significant differences in age, education level and marital status between the two groups before matching(t=42.560, χ¹=126.614, 191.320, P<0.001). After matching, there was no statistically significant differences in demographic characteristics between the two groups(P>0.05). The results of multivariate logistic regression analysis showed that smoking cessation (OR=1.168, 95%CI:1.008-1.396), chronic diseases (1-2 categories, OR=1.433, 95%CI:1.107-1.687;≥3 categories, OR=1.566, 95%CI:1.269-1.931), no social activities(OR=0.617, 95%CI:0.515-0.741), no long-term care (OR=0.573, 95%CI:0.496-0.661), had pension or retirement (OR=1.221, 95%CI:1.034-1.443), and satisfaction with medical services (general satisfaction, OR=1.375, 95%CI: 1.127-1.678; satisfaction, OR=1.531, 95%CI:1.257-1.865)were independent influencing factors of the utilization of community home-based elderly care services (P<0.05). Conclusion Advocating healthy lifestyle, strengthening health management, encouraging social activities, strengthening long-term care and improving the level of community medical services can effectively promote the use of community home-based elderly care services for the Chinese elderly.