Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, China.
J Public Health (Oxf). 2009 Dec;31(4):530-40. doi: 10.1093/pubmed/fdp007. Epub 2009 Feb 6.
In this study, we determined the prevalence of unmet need for hospitalization service and the characteristics of the elderly with this unmet need in Zhejiang province, China.
Data were collected from a random sample of 4046 Chinese aged 60 years and older in Zhejiang province. Based on the Andersen-Newman service utilization framework, multivariable logistic regression analysis was used to determine independent effects of these variables on the likelihood of having an unmet need for hospitalization service.
Overall, the prevalence of unmet need was 16.2% for hospitalization service. Among predisposing factors, only educational level was statistically significant. Individuals with higher education were less likely to report unmet needs. Among enabling factors, residential area, social support, personal yearly income and personal healthcare expenditure were strongly associated with the presence of unmet need. Those with less enabling resources (e.g. residing in rural areas) were more likely to report unmet need [Odds ratio (OR) = 1.5-6.5]. All the need factors, except for physical function, were strongly associated with the presence of unmet need. Seniors in poorer health (e.g. in fair or poor health) were more likely to report unmet need than their counterparts in better health (OR = 1.5-2.8).
In spite of relatively high insurance coverage rates, unmet need for hospitalization service remains high among the elderly people of Zhejiang province in China. Application of comprehensive intervention strategies such as conducting health education, creating social support, promoting community participation and promoting inter-sectional cooperation may be more effective in reducing unmet need for hospitalization service.
本研究旨在确定中国浙江省老年人住院服务未满足需求的流行情况及其特征。
数据来自浙江省随机抽取的 4046 名 60 岁及以上的中国老年人。基于安德森-纽曼服务利用框架，采用多变量逻辑回归分析确定这些变量对住院服务未满足需求的可能性的独立影响。
总体而言，住院服务未满足需求的比例为 16.2%。在倾向因素中，只有教育程度具有统计学意义。教育程度较高的人不太可能报告存在未满足的需求。在促成因素中，居住地区、社会支持、个人年收入和个人医疗保健支出与未满足的需求密切相关。那些资源较少的人（如居住在农村地区）更有可能报告存在未满足的需求[比值比（OR）=1.5-6.5]。除了身体功能外，所有需求因素都与未满足的需求密切相关。健康状况较差的老年人（如健康状况一般或较差）比健康状况较好的老年人更有可能报告存在未满足的需求（OR=1.5-2.8）。
尽管保险覆盖率相对较高，但中国浙江省老年人的住院服务仍有较高的未满足需求。应用综合干预策略，如开展健康教育、建立社会支持、促进社区参与和促进跨部门合作，可能更有效地减少住院服务的未满足需求。
