个体、家庭和社区因素对机构养老意愿的影响：中国老年人的横断面调查。
Effects of individual, family and community factors on the willingness of institutional elder care: a cross-sectional survey of the elderly in China.
机构信息
Department of Health Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
SHS BG/H06, BOE Health Investment Management, Beijing, China.
出版信息
BMJ Open. 2020 Feb 18;10(2):e032478. doi: 10.1136/bmjopen-2019-032478.
OBJECTIVE
To investigate the effects of the willingness to live in elder care institutions associated with individual factors, family environment and the community environment in the elderly in China.
DESIGN
Cross-sectional survey.
SETTING
Heilongjiang Province, China.
PARTICIPANTS
A total of 1003 elderly people were selected through multistage sampling in Heilongjiang Province.
PRIMARY AND SECONDARY OUTCOME MEASURES
A multistage, stratified sampling design was employed. Differences in health status, family environment and community environment of the respondents were compared with the t-test and χ test. Logistic regression analysis was performed to assess key determinants of willingness to live in institutions.
RESULTS
This study showed that 45.4% of respondents were willing to live in elder care institutions in the future. Factors influencing willingness to live in elder care institutions were age, house ownership, living with spouse and children, disease caregivers and availability of home healthcare services. The elders who had no property (OR=2.37, 95% CI 1.750 to 3.200, p<0.01) and those aged 80 or above (OR=2.25, 95% CI 1.490 to 3.400, p<0.01) were, respectively, 2.370 and 2.250 times more receptive to living in elder care institutions than their control groups. However, those living with a spouse (OR=0.47, 95% CI 0.287 to 0.762, p<0.01), living with children (OR=0.25, 95% CI 0.158 to 0.402, p<0.01) or living with a spouse and children (OR=0.29, 95% CI 0.160 to 0.509, p<0.01) were less willing to live in elder care institutions.
CONCLUSIONS
These results suggest that the willingness to enter elder care institutions is affected by individual, family environmental and community environmental factors. We should vigorously develop community-centred intensive home-based elder care services by improving the quality and availability of home health services by expanding investment in the community.
目的
调查中国老年人入住养老院的意愿与个体因素、家庭环境和社区环境的关系。
设计
横断面调查。
地点
中国黑龙江省。
参与者
采用多阶段抽样方法，在中国黑龙江省共选取 1003 名老年人。
主要和次要观察指标
采用多阶段、分层抽样设计。采用 t 检验和 χ²检验比较了受访者的健康状况、家庭环境和社区环境差异。采用 logistic 回归分析评估了入住养老院意愿的关键决定因素。
结果
本研究显示，45.4%的受访者未来愿意入住养老院。影响入住养老院意愿的因素包括年龄、住房所有权、与配偶和子女同住、疾病照顾者和家庭医疗保健服务的可用性。无房（OR=2.37，95%CI 1.750 至 3.200，p<0.01）和 80 岁及以上（OR=2.25，95%CI 1.490 至 3.400，p<0.01）的老年人入住养老院的意愿分别是对照组的 2.370 和 2.250 倍。然而，与配偶同住（OR=0.47，95%CI 0.287 至 0.762，p<0.01）、与子女同住（OR=0.25，95%CI 0.158 至 0.402，p<0.01）或与配偶和子女同住（OR=0.29，95%CI 0.160 至 0.509，p<0.01）的老年人入住养老院的意愿较低。
结论
这些结果表明，入住养老院的意愿受个体、家庭环境和社区环境因素的影响。我们应该大力发展以社区为中心的强化家庭养老服务，通过扩大对社区的投资，提高家庭医疗服务的质量和可及性。
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