BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.
STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.
Wiad Lek. 2021;74(3 cz 2):658-664.
The aim: The identification and determination of needs that the population of older age groups have in medical and social services on the basis of health data and the results of a survey.
Material and methods: Because of bibliographic, epidemiological, medical-statistical, analytical methods the research has investigated the problems of healthy aging, tendencies in population health of the population of Ukraine of senior age groups during 2000-2017, features and tendencies of health of a sample contingent of urban population of elderly age according to appeals in health care facilities during 2009-2019. The use of the sociological method, the self-evaluation of elderly people of their own health, characteristics of lifestyle and medical activity are determined, the needs of older people in medical and social services were assessed.
Results: Negative tendencies to increase during 2000-2017 the prevalence of pathology among the population older than working age by 22.8%, including blood diseases in 2 times, endocrine system - in 1.8 times, urogenital system - by 1.5 times, digestive organs - by 1.4 times, tumors and nervous system - by 1.3 times. Among the urban elderly population, the prevalence of sensory diseases, including ear and eye diseases, endocrine disorders, injuries and poisonings, has increased, and mental health indicators have deteriorated. The sociological survey found a low level of self-esteem (31.5±3.5 per 100 had health problems, 10.1±2.3 are significant). Self-medication was practiced by 76.4±3.2 per 100 respondents, 74.2±3.3 were not followed or they violated the doctor's recommendations. 56.2 ±3.7 per 100 respondents had physical examinations in the non-right time 29.7±3.4 had not it.There was a significant prevalence of risk factors, including hypodynamics (21.9±3.1 per 100), tobacco use (29.8±3.4), malnutrition (37.1±3.6), overweight (obesity) (32, 6±3.5), arterial hypertension (37.6±3.6), hypercholesterolemia (28.7±3.4), glucosemia 16.3±2.8). The research has discovered the needs of older people in health care and social services, inter alia in preventive counseling (65.2±3.6 per 100), the introduction of electronic technologies in health care (68.5±3.5), information educational services on health issues (67.4±3.5), provision of services in hospitals at home (66.3±3.5), in increasing the availability of rehabilitation (43.8±3.7), specialized counseling (34.3±3.6) and emergency medical care (16.2±2.8), improvement of socio-economic determinants (78.0±3.1), introduction of activities (48.3±3.7), joint training programs for older people (42.1±3.7), the development of certain skills, the use of technical means, assistive devices (67.4±3.5), the formation of a conducive to better health environment (58, 4±3.7).
Conclusions: The low level of the elderly people's health, the tendency to increase the burden of disease, the prevalence of risk factors for disease and low medical activity lead tosignificant needs for medical and social services of preventive, treatment-diagnostic, rehabilitation, improving socio-economic determinants, measures to reduce social isolation.
目的：基于健康数据和调查结果，确定和确定老年人群体在医疗和社会服务方面的需求。
材料和方法：由于文献、流行病学、医学统计学、分析方法的研究，调查了 2000-2017 年期间乌克兰老年人口健康老龄化的问题、2009-2019 年期间城市老年人口卫生保健机构就诊的老年人口健康特征和趋势。使用社会学方法，自我评估老年人的健康状况、生活方式和医疗活动的特点，评估老年人对医疗和社会服务的需求。
结果：2000-2017 年期间，与工作年龄以上人群相比，血液疾病增加了 2 倍，内分泌系统增加了 1.8 倍，泌尿生殖系统增加了 1.5 倍，消化系统增加了 1.4 倍，肿瘤和神经系统增加了 1.3 倍，老年人口中患病的流行率呈负向增长趋势。在城市老年人口中，感官疾病（包括耳眼疾病、内分泌紊乱、损伤和中毒）的发病率增加，心理健康指标恶化。社会学调查发现，自我评估水平较低（100 人中 31.5%±3.5 人有健康问题，10.1%±2.3 人有显著问题）。76.4%±3.2%的受访者自行用药，74.2%±3.3%的受访者未遵循或违反医生建议。56.2%±3.7%的受访者在非正确时间进行体检，29.7%±3.4%的受访者没有体检。存在显著的危险因素流行率，包括运动不足（100 人中 21.9%±3.1%）、吸烟（29.8%±3.4%）、营养不良（37.1%±3.6%）、超重（肥胖）（32.6%±3.5%）、动脉高血压（37.6%±3.6%）、高胆固醇血症（28.7%±3.4%）、高血糖症 16.3%±2.8%）。研究发现，老年人对医疗和社会服务的需求，包括预防性咨询（100 人中 65.2%±3.6%）、医疗保健中电子技术的引入（68.5%±3.5%）、健康问题信息教育服务（67.4%±3.5%）、家庭医院服务的提供（66.3%±3.5%）、康复服务可用性的提高（43.8%±3.7%）、专门咨询（34.3%±3.6%）和紧急医疗护理（16.2%±2.8%），改善社会经济决定因素（78.0%±3.1%）、活动的引入（48.3%±3.7%）、老年人联合培训计划（42.1%±3.7%）、某些技能的发展、技术手段的使用、辅助设备（67.4%±3.5%）、形成有利于改善健康的环境（58.4%±3.7%）。
结论：老年人健康水平低、疾病负担增加趋势、疾病危险因素流行率高以及医疗活动水平低，导致对预防、治疗-诊断、康复、改善社会经济决定因素、减少社会隔离的医疗和社会服务有显著需求。
