Liu Siqi, Zhao Jun, Liu Nan, Qin Tingting, Wang Fang
Center of Health System and Policy, Institute of Medical Information & Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
Department of Science and Technology, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.
Patient Prefer Adherence. 2025 Jan 14;19:107-122. doi: 10.2147/PPA.S495034. eCollection 2025.
Population aging and epidemiological transition have prompted requests for integrating health and social care. The goal of meeting complex care needs necessitates the understanding of preferred patterns among older adults. The study aimed to elicit the preferred care patterns and the influencing factors of integrated health and social care among community-dwelling older adults in multiple regions of China.
From a national survey, 1184 community-dwelling older adults in three cities across China were included in the study. Individual characteristics and preferred care patterns were measured. Five preferred care patterns were classified, including Home-based health and social care, Community-based health and social care, Home-based health care but community-based social care, Community-based health care but home-based social care, and Institution-based health and social care. Multivariate logistic regression and random forest model were applied to obtain reliable results.
Overall, approximately half of the participants (47.7%) in the survey preferred Home-based health and social care and more than a quarter of participants (25.6%) preferred Community-based health and social care, followed by Institution-based health and social care (14.4%). A relatively small fraction of participants reported preferences for Home-based health care but community-based social care (8.0%) and Community-based health care but home-based social care (4.2%). Gender, age, education, living arrangement, resident city, income per month, access to medication, and self-care capability were significantly associated with older adults' preferences (p<0.05 each). Education, living arrangement, age, resident city, and income per month were the most relevant predictors, followed by gender, number of chronic diseases, self-care capability, and access to medication.
To effectively meet care needs, efforts should focus on home- and community-based care. Since the preferred care patterns were characterized by obvious variability, policymakers and service providers should carefully consider the differences in making tailored strategies.
人口老龄化和流行病学转变促使人们要求整合健康与社会护理。满足复杂护理需求的目标需要了解老年人的偏好模式。本研究旨在探究中国多个地区社区居住老年人对整合健康与社会护理的偏好护理模式及其影响因素。
从一项全国性调查中,选取了中国三个城市的1184名社区居住老年人纳入研究。测量了个体特征和偏好护理模式。分类出五种偏好护理模式,包括居家健康与社会护理、社区健康与社会护理、居家健康护理但社区社会护理、社区健康护理但居家社会护理以及机构健康与社会护理。应用多变量逻辑回归和随机森林模型以获得可靠结果。
总体而言,调查中约一半的参与者(47.7%)偏好居家健康与社会护理,超过四分之一的参与者(25.6%)偏好社区健康与社会护理,其次是机构健康与社会护理(14.4%)。相对较少比例的参与者表示偏好居家健康护理但社区社会护理(8.0%)和社区健康护理但居家社会护理(4.2%)。性别、年龄、教育程度、居住安排、居住城市、月收入、用药便利性和自我护理能力与老年人的偏好显著相关(各p<0.05)。教育程度、居住安排、年龄、居住城市和月收入是最相关的预测因素,其次是性别、慢性病数量、自我护理能力和用药便利性。
为有效满足护理需求,应将重点放在居家和社区护理上。由于偏好护理模式具有明显的变异性,政策制定者和服务提供者在制定针对性策略时应仔细考虑这些差异。