基于安德森模型的中国河南省残疾老年人机构护理利用意愿及其影响因素的横断面调查。

Utilisation willingness for institutional care by the disabled elderly and its influencing factors based on Andersen's model: a cross-sectional survey of Henan, China.

机构信息

Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China.

Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China

出版信息

BMJ Open. 2022 Dec 9;12(12):e064949. doi: 10.1136/bmjopen-2022-064949.

DOI:10.1136/bmjopen-2022-064949

PMID:36600340

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9743373/

Abstract

OBJECTIVE

To explore the factors that influence institutional care for the disabled elderly in China and the key factors that influence individuals based on the Andersen model.

DESIGN

Cross-sectional survey.

SETTING

The research was conducted in 18 cities in Henan Province, China.

MAIN OUTCOME MEASURES

A multistage, stratified sampling design was employed. The χ test was used to compare the differences in basic information of the disabled elderly. A binary Logit model was used to examine the factors influencing the willingness to institutionalise elderly people with disabilities. The determinants of willingness to care in an institution were also explored in a stratified study by gender, age and region to identify the key differences affecting institutionalisation. The Andersen model was used as the theoretical framework to infer the impact strength of each model.

RESULTS

Of the 2810 disabled elderly people in Henan, China, 7.4% of the elderly had a willingness for institutional care. In the binary logistic regression analysis, whether living alone (OR (95% CI)=0.596 (0.388 to 0.916)), medical payment method (basic medical insurance for urban employees: OR (95% CI)=2.185 (1.091 to 4.377)), having mental illness (OR (95% CI)=2.078 (1.044 to 4.137)) had a statistically significant difference (p<0.05) on the impact on the willingness of the disabled elderly to receive institutional care. Validation of the fitted coefficients of the model revealed that the needs factor had the most significant effect on the enabling variable, while the predisposing factor had more minerally effect.

CONCLUSIONS

Several factors influence the willingness of the disabled elderly to institutionalise. Therefore, it is recommended that relevant authorities take targeted measures to focus on the disabled elderly to identify more precise elderly care services to deal with the ageing crisis.

摘要

目的

基于安德森模型，探讨我国失能老人机构照护意愿的影响因素及其个体影响因素的关键因素。

设计

横断面调查。

地点

在中国河南省的 18 个城市进行研究。

主要结局测量

采用多阶段、分层抽样设计。采用 χ 检验比较失能老人基本信息的差异。采用二元 Logit 模型检验影响失能老人入住意愿的因素。还通过性别、年龄和地区分层研究探讨了愿意入住机构的决定因素，以确定影响机构入住的关键差异。采用安德森模型作为理论框架，推断每个模型的影响强度。

结果

在中国河南省的 2810 名失能老人中，有 7.4%的老人有机构照护意愿。在二元逻辑回归分析中，是否独居（OR（95%CI）=0.596（0.388 至 0.916））、医疗支付方式（城镇职工基本医疗保险：OR（95%CI）=2.185（1.091 至 4.377））、患有精神疾病（OR（95%CI）=2.078（1.044 至 4.137））对失能老人接受机构照护的意愿有统计学意义（p<0.05）。对模型拟合系数的验证表明，需求因素对使能变量的影响最大，而倾向因素的影响较小。