利用社区护理服务和自评健康在中国的老年人口：基于倾向评分匹配方法的调查分析。
Utilisation of community care services and self-rated health among elderly population in China: a survey-based analysis with propensity score matching method.
机构信息
School of Public Policy and Administration, Xi'an Jiaotong University, People's Republic of China, No 28 West Road, Xi'an, Xianning, 710049, Shaanxi, China.
出版信息
BMC Public Health. 2021 Oct 25;21(1):1936. doi: 10.1186/s12889-021-11989-x.
BACKGROUND
Elderly care and elderly health are the enormous challenges in such an aging society as China. Community care services have been developing rapidly in recent years in China as an increasingly mainstream care resource to promote elderly health. The purpose of this study is to examine the association between using community care services and self-rated health among Chinese elderly.
METHODS
A cross-sectional survey was conducted in 2019 and 612 elderly people from China's Shaanxi province were enrolled. The binary logistic regression was first employed to explore the association between community care services utilisation and elderly health. Given the potential selection bias issue, the propensity score matching method was hired to generate comparable samples between participants who used these services and participants who didn't, and further examine the health benefits of using four types of services.
RESULTS
The results of the binary logistic regression showed that the use of community care services predicted a better health status of elderly individuals. Overall, the results of the propensity score matching method showed the similar results. Specifically, with the nearest neighbors matching algorithm, using daily care services was significantly associated with a 0.246 increase in the self-rated health of the elderly (T = 1.83). For medical care services, the mean of self-rated health of elderly individuals who used these services was 3.542, significantly higher than those who didn't (T = 2.15). For spiritual comfort services, elderly individuals using these services showed a significant increase by 0.280 in the self-rated health (T = 1.82). For social and recreational services, the result of the nearest neighbor matching method was not statistically significant, while the results of kernel matching method and the mahalanobis matching method showed a significant increase in the self-rated health among elderly individuals using these services (T = 2.03, T = 2.03, respectively). All the estimated results passed the Rosenbaum bounds analysis and were not sensitive to hidden bias.
CONCLUSIONS
Using community care services improved the self-rated health of the elderly. More effective measures may be implemented to increase access to care resources for senior citizens, and further improve their health status.
背景
在中国这样一个老龄化社会，老年人护理和健康是巨大的挑战。近年来，社区护理服务在中国迅速发展，成为促进老年人健康的主流护理资源之一。本研究旨在探讨中国老年人使用社区护理服务与自我健康评估之间的关系。
方法
本研究采用横断面调查方法，于 2019 年在中国陕西省招募了 612 名老年人。首先采用二元逻辑回归模型探讨社区护理服务利用与老年人健康之间的关系。鉴于潜在的选择偏差问题，采用倾向评分匹配法生成使用这些服务的参与者和未使用这些服务的参与者之间可比的样本，并进一步检验使用四种类型服务的健康获益。
结果
二元逻辑回归结果显示，使用社区护理服务可预测老年人的健康状况更好。总体而言，倾向评分匹配法的结果也显示出相似的结果。具体而言，采用最近邻匹配算法，使用日常护理服务与老年人自我健康评分提高 0.246 显著相关（T=1.83）。对于医疗护理服务，使用这些服务的老年人的自我健康评分均值为 3.542，显著高于未使用这些服务的老年人（T=2.15）。对于精神慰藉服务，使用这些服务的老年人自我健康评分显著提高 0.280（T=1.82）。对于社会和娱乐服务，最近邻匹配法的结果在统计学上不显著，而核匹配法和马哈拉诺比斯匹配法的结果显示，使用这些服务的老年人自我健康评分显著提高（T=2.03，T=2.03）。所有估计结果均通过罗森鲍姆边界分析，且不受潜在偏差的影响。
结论
使用社区护理服务可改善老年人的自我健康评估。可能需要实施更有效的措施，以增加老年人获得护理资源的机会，并进一步提高他们的健康状况。
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