School of Surveying and Land Information Engineering, Henan Polytechnic University, Jiaozuo, Henan, China.
Medicine (Baltimore). 2023 Jul 21;102(29):e34374. doi: 10.1097/MD.0000000000034374.
The aging of the population is becoming an increasingly severe issue. How can we develop caring services for the elderly and promote healthy aging? Investigating care preferences is an essential step in addressing this issue. A self-designed questionnaire was employed to collect data online. The impact of personal circumstances on care preferences was ascertained using the chi-squared test and multivariate logistic regression. An optimal parameters-based geographical detector was introduced to examine the influence of spatially heterogeneous regional factors on care preferences. The online survey produced 1178 valid questionnaires. Home-based elderly care was the preference of 91.9% of respondents, followed by community-based care and medical-nursing care; institutional care was the least preferred alternative. Age, education, living style, and health states of the elderly significantly influenced the preferred care option. When compared to home-based elderly care, older respondents (odds ratio [OR] = 3.776) preferred institutional care, highly educated respondents preferred community-based care (higher education: OR = 5.206; secondary education: OR = 3.049) and medical-nursing care (higher education: OR = 4.484); the elderly living alone (OR = 0.101) excluded institutional care, and the elderly living with their children excluded non-family care method of institutional care (OR = 0.031) and medical-nursing care (OR = 0.391). Regional medical resources and old-age security significantly affect the preferences of the elderly (q-statistic [q] > 0.5); local economic development significantly affects community-based care (q > 0.6); the availability of financial subsidies significantly affects home-based care and medical-nursing care (q > 0.9); and the availability of institutional resources significantly affects the preference for institutional care (q > 0.8). We found that it is necessary to improve the level of medical care given by non-family members and care facilities, vigorously develop new methods of elderly care, promote humanistic care in non-family care settings, and increase available regional medical resources, financial subsidies, and social security. This study integrates economic and social perspectives to examine and analyze retirement willingness, thereby broadening the scope of social surveys and research methodologies, and offering valuable insights with potential directive implications.
人口老龄化问题日益严峻。我们应该如何发展老年关爱服务，促进健康老龄化呢？研究养老照护偏好是解决这一问题的重要步骤。本研究采用自行设计的问卷，通过在线方式收集数据。采用卡方检验和多因素逻辑回归分析个人情况对养老照护偏好的影响。引入最优参数地理探测器检验养老照护偏好的空间异质性区域因素的影响。本次在线调查共获得 1178 份有效问卷。91.9%的受访者首选居家养老，其次是社区养老和医养结合，机构养老最不受欢迎。老年人的年龄、受教育程度、生活方式和健康状况显著影响其选择的照护方式。与居家养老相比，年龄较大的老年人（优势比[OR] = 3.776）更倾向于选择机构养老；受教育程度较高的老年人（高等教育：OR = 5.206；中等教育：OR = 3.049）和医养结合（高等教育：OR = 4.484）更倾向于选择社区养老；独居老年人（OR = 0.101）更排斥机构养老；与子女同住的老年人更排斥非家庭养老方式的机构养老（OR = 0.031）和医养结合（OR = 0.391）。区域医疗资源和老年保障显著影响老年人的偏好（q 统计量 [q] > 0.5）；当地经济发展显著影响社区养老（q > 0.6）；财政补贴的提供显著影响居家养老和医养结合（q > 0.9）；机构资源的提供显著影响机构养老的偏好（q > 0.8）。研究发现，需要提高非家庭成员和养老机构的医护水平，大力发展新的养老方式，促进非家庭养老环境的人文关怀，增加区域医疗资源、财政补贴和社会保障。本研究从经济和社会角度综合考察和分析了退休意愿，拓宽了社会调查和研究方法的范围，提供了具有潜在指导意义的有价值见解。
