医养结合下老年人医疗消费行为影响因素分析—以南京市为例

  目的  通过对南京市居民进行问卷调查，了解南京市居民对长期护理保险的参保意愿并分析其影响因素，为建立和发展长期护理保险制度提供参考。  方法  于2017年10月 — 2018年4月利用方便抽样方法抽取符合条件的居民进行问卷调查，共收集1 532份有效问卷。采用χ²检验和二元logistic回归分析居民参保意愿的影响因素。  结果  在被调查的1 532名南京市居民中，男性744人（48.56 %），女性788人（51.44 %）；45.17 %（692/1 532）的受调查者表示愿意参加长期护理保险；二元logistic回归分析结果显示，初中（OR = 2.286，95 % CI = 1.335～3.912）和研究生及以上学历（OR = 3.205，95 % CI = 1.812～5.667）、高年医药费用支出（OR = 3.278，95 % CI = 1.845～5.823）、听说过长期护理保险（OR = 2.378，95 % CI = 1.798～3.146）为影响居民对长期护理保险参保意愿的正面因素（P < 0.05），女性（OR = 0.794，95 % CI = 0.634～0.993）、40～59岁（OR = 0.450，95 % CI = 0.244～0.828）、丧偶（OR = 0.453，95 % CI = 0.233～0.881）是影响居民对长期护理保险参保意愿的负面因素（P < 0.05）。  结论  调查对象对于长期护理保险认知度和参保意愿不高，影响参保意愿的主要因素包括性别、文化程度、婚姻状况、年医药费用支出和是否听说过长期护理保险等。

Willingness to participate in long-term care insurance and its influencing factors among urban residents in Nanjing city: a cross-sectional survey

  Objective  To examine willingness and associates of participating in long-term care insurance (LTCI) among urban residents in Nanjing city for providing references to establish and improve LTCI system.  Methods  Using convenient sampling, we recruited 1 700 adult residents (18 – 79 years old) in an urban community of Nanjing city and conducted a questionnaire survey from October 2017 to April 2018. Univariate statistics and binary logistic regression analysis were adopted to analyze influencing factors of willingness of LTCI participation.  Results  Of the 1 532 residents (mean age of 54.52 ± 15.72 years, 48.56% and 51.44% being male and female) with valid informantion, 45.17% reported the willingness to participate in LTCI. The results of binary logistic regression analysis revealed that the participants with following characteristics were more likely to have the willingness to participate in LTCI: having the education equal to or higher than junior high school (odd ratio [OR] = 2.286, 95% confidence interval [CI]: 1.335 – 3.912) or graduate (OR = 3.205, 95% CI: 1.812 – 5.667), with a high annual medical expenses (OR = 3.278, 95% CI: 1.845 – 5.823), and being aware of LTCI (OR = 2.378, 95% CI: 1.798 – 3.146); while the participants being female (OR = 0.794, 95% CI: 0.634 – 0.993), aged 40 – 59 years (OR = 0.450, 95% CI: 0.244 – 0.828), and being widowed (OR = 0.453, 95% CI: 0.233 – 0.881) were less likely to have the willingness.  Conclusion  Both the awareness and willingness of participating in long-term care insurance are at a low level and the willingness is influenced mainly by gender, education, marital status, annual medical expenses, and related awareness among urban adult residents in Nanjing city.