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墨西哥促进积极老龄化的社会卫生服务模式:一项试点计划的设计与评估

A social health services model to promote active ageing in Mexico: design and evaluation of a pilot programme.

作者信息

Pérez-Cuevas Ricardo, Doubova Svetlana V, Bazaldúa-Merino Laura Angélica, Reyes-Morales Hortensia, Martínez David, Karam Roberto, Gamez Carlos, Muñoz-Hernández Onofre

机构信息

Division of Social Protection and Health , Inter-American Development Bank , Mexico City , Mexico .

Epidemiology and Health Services Research Unit CMN Siglo XXI , Mexican Institute of Social Security , Mexico City , Mexico .

出版信息

Ageing Soc. 2015 Aug;35(7):1457-1480. doi: 10.1017/S0144686X14000361. Epub 2014 May 23.

Abstract

The objective of the study was to design and evaluate a pilot programme aimed at promoting the active ageing of older adults at the Mexican Institute of Social Security. The study was conducted in three stages: (a) design; (b) implementation; and (c) before-after evaluation through analysis of changes in functional status, occupational functioning and health-related quality of life. To overcome the limitations of the study design, we evaluated the effect of 80 per cent adherence to the programme on the outcome variables using the generalised linear regression models (GLM). Two hundred and thirty-nine older adults agreed to participate, of whom 65 per cent completed the programme. Most were women; the average age was 77 years. Adherence to the programme was higher than 75 per cent for the group who completed active ageing services and less than 60 per cent for the drop-out group. Overall, 46 per cent of older adults reached an adherence level of 80 per cent or higher. Adherence was significantly associated with improved quality of life total score (coefficient 2.7, <0.0001) and occupational functioning total score (coefficient 2.2, <0.0001). Participation of older adults in an active ageing programme may improve their health-related quality of life and occupational functioning. It is necessary to identify the potential barriers and to implement strategies to improve the recruitment and retention rates during the intervention.

摘要

该研究的目的是设计并评估一项试点计划,旨在促进墨西哥社会保障局老年人的积极老龄化。该研究分三个阶段进行:(a) 设计;(b) 实施;以及 (c) 通过分析功能状态、职业功能和健康相关生活质量的变化进行前后评估。为克服研究设计的局限性,我们使用广义线性回归模型 (GLM) 评估了80% 的计划依从性对结果变量的影响。239名老年人同意参与,其中65% 完成了该计划。大多数是女性;平均年龄为77岁。完成积极老龄化服务的组对计划的依从性高于75%,而退出组则低于60%。总体而言,46% 的老年人达到了80% 或更高的依从水平。依从性与生活质量总分改善(系数2.7,<0.0001)和职业功能总分改善(系数2.2,<0.0001)显著相关。老年人参与积极老龄化计划可能会改善他们的健康相关生活质量和职业功能。有必要识别潜在障碍并实施策略,以提高干预期间的招募率和保留率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e7f/4501303/f3c0ced01e07/S0144686X14000361_fig1.jpg

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