印度老年人的支持性和姑息治疗需求：基于全国代表性调查的估计。

Supportive and palliative care needs among older adults in India: an estimation using a nationally representative survey.

机构信息

SRMIST (Deemed to be University), School of Public Health, Kattankulathur, Chennai, Tamil Nadu, 603203, India.

Department of Palliative Medicine and Supportive Care, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India.

出版信息

BMC Palliat Care. 2024 Nov 30;23(1):274. doi: 10.1186/s12904-024-01604-2.

DOI:10.1186/s12904-024-01604-2

PMID:39616320

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11608499/

Abstract

BACKGROUND

One in five people will be older than 60 by the year 2050 in India. This demographic transition demands integration of geriatric and palliative care. The national level burden of palliative and supportive care needs of the older population is largely unknown in India. This study estimates the burden of palliative care needs among the older population in India from a nationally representative survey - Longitudinal Ageing Study of India (LASI).

METHODS

The general indicators of poor or deteriorating health from the Supportive and Palliative Care Indicator Tool for Low Income Setting were used to identify older adults with palliative care needs. These indicators were compared with the LASI data and matched with the appropriate variables. Descriptive statistical analysis, chi-square tests and multivariate logistic regression were done to estimate palliative care needs and its association with other characteristics.

RESULTS

12.2% of Indian older adults have supportive and palliative care needs. Among Indian states, highest for West Bengal (17%), Madhya Pradesh (16.9%), and Bihar (16.3%) while lowest in Arunachal Pradesh (2.2%), Nagaland (2.4%), and Mizoram (3%). High needs were found among those aged 70 years and above (AOR-1.86), females (AOR-1.33), Muslim religion (AOR-1.24), rural residents (AOR-1.72), those who experienced ill-treatment (OR-1.75), with cancer (AOR-2.84), respiratory disease (AOR-3.14), and stroke (AOR-2.58). Lower needs were observed with higher education (AOR-0.43) and health insurance (AOR-0.83).

CONCLUSION

This is the first study in India that estimates the need for supportive and palliative care using a nationally representative sample. One among eight older adults in India has supportive and palliative care needs. The needs are higher among female older adults, rural residents, older adults with chronic diseases, and in poorer States. Screening and early integration of palliative care with routine healthcare care is essential to meet these needs.

摘要

背景

到 2050 年，印度将有五分之一的人口年龄超过 60 岁。这种人口结构的转变要求将老年医学和姑息治疗相结合。印度全国范围内老年人姑息治疗和支持性护理需求的负担在很大程度上是未知的。本研究使用来自全国代表性调查——印度纵向老龄化研究（LASI）的数据来估计印度老年人口的姑息治疗需求负担。

方法

使用来自低收入环境支持性和姑息治疗指标工具的一般健康状况不良或恶化指标来确定有姑息治疗需求的老年人。这些指标与 LASI 数据进行比较，并与相应的变量相匹配。进行描述性统计分析、卡方检验和多变量逻辑回归，以估计姑息治疗需求及其与其他特征的关联。

结果

12.2%的印度老年人有支持性和姑息治疗需求。在印度各邦中，西孟加拉邦（17%）、中央邦（16.9%）和比哈尔邦（16.3%）的需求最高，而阿鲁纳恰尔邦（2.2%）、那加兰邦（2.4%）和米佐拉姆邦（3%）的需求最低。70 岁及以上的老年人（AOR-1.86）、女性（AOR-1.33）、穆斯林宗教（AOR-1.24）、农村居民（AOR-1.72）、遭受虐待的老年人（OR-1.75）、癌症患者（AOR-2.84）、呼吸系统疾病患者（AOR-3.14）和中风患者（AOR-2.58）的需求较高。较高的教育水平（AOR-0.43）和医疗保险（AOR-0.83）则降低了需求。