海口市老年人健康状况及居家养老医疗服务需求调查分析

目的 了解海口市老年人健康状况及居家养老医疗服务需求，为制定卫生规划提供科学依据。方法 采用多阶段整群随机抽样方法抽取海口市60岁以上老年人3 601名，通过入户问卷调查了解老年人基本情况、慢性病患病情况、养老方式选择以及对居家医疗服务需求。结果 共回收有效问卷3 544份，有效应答率98.42%。老年人文化程度主要以小学及以下为主，占43.68%,93.28%的老人与配偶和(或)子女同住，6.30%的老人独居；4.77%的老年人生活不能自理，30.11%的老年人部分自理需要照顾。60岁以上老年人慢性病患病率为65.83%,其中高血压、糖尿病、冠心病、脑卒中、精神或心理疾病、慢性阻塞性肺疾病、消化系统疾病、骨及关节疾病以及其他疾病患病率依次为31.94%、13.54%、2.51%、2.51%、0.90%、2.20%、3.02%、4.23%和17.41%。78.89%老年人选择居家养老并有居家养老医疗服务需求，11.91%老年人选择机构养老。二元logistic回归分析结果显示家庭关系、自评健康状况与居家养老医疗服务需求存在相关性；居家养老医疗服务费用可接受范围在1 000元以下的占70...

Health status of the elderly and the demands for medical services of home-based elderly care in Haikou City

Objective To understand the health status of senior citizens and the needs for medical services of home-based elderly care in Haikou City, and to provide a scientific basis for formulation of health planning. Methods A multi-stage cluster random sampling method was used to select 3,601 senior citizens aged above 60 years in Haikou City. Through household questionnaire survey, we investigated general information of the elderly, incidence of chronic diseases, choice of way of old-age care and demands for home-based medical services. Results A total of 3,544 valid questionnaires were collected, with an effective response rate of 98.42%. Most the elderly were the primary school and below education level, accounting for 43.68%. 93.28% of the elderly lived with their spouses and/or children, and 6.30% lived alone. 4.77% of the elderly could not take care of themselves, and 30.11% of the elderly needed to be taken care partially. The prevalence rate of chronic diseases in the elderly aged above 60 years was 65.83%, of which the prevalence rates of hypertension, diabetes, coronary heart disease, stroke, mental or psychological diseases, chronic obstructive pulmonary disease, digestive system diseases, bone and joint diseases and other diseases were 31.94%, 13.54%, 2.51%, 2.51%, 0.90%, 2.20%, 3.02%, 4.23% and 17.41%, respectively. 78.89% of the elderly chose home-based elderly care and had medical service needs. 11.91% of the elderly chose institutions for old-age care service. The results of binary logistic regression analysis displayed that family relationship, self-evaluated health statuswere correlated with demands for medical services of home-based elderly care. The acceptable range of medical service fee of home-based elderly care was less than 1,000 yuan, accounting for 70.67%. The top five medical service items expected to be provided were regular physical examination (37.69%), diagnosis and treatment of diseases (17.17%), preventive health care (16.72%), health education (9.70%) and rehabilitation nursing (6.90%). The top five types of services expected to beprovided were patients' direct access to institutions (54.25%), doctors' regular door-to-door services (29.18%), professional nursing home-to-door services (8.26%), doctors' appointment door-to-door services (2.64%) and community lectures on geriatric diseases (2.07%). Conclusion The prevalence rate of chronic diseases among the elderly in Haikou City is high. Home-based elderly care is the preferred way of elderly care, and the demands for medical services of home-based elderly care are high. An effective service system for home-based elderly care should be established according to the service demands so as to provide multi-form and multi-channel medical services of home-based elderly care for senior citizens.