Zhou Yilin, Tian Xiaoqin, Tang Yuqin, Peng Peng, Deng Dan
Department of Health Statistics, College of Public Health, Chongqing Medical University, Chongqing, China.
Front Public Health. 2025 Jun 11;13:1581039. doi: 10.3389/fpubh.2025.1581039. eCollection 2025.
Using an urban area in southwest China as a case study, this research investigates and analyzes the supply and demand of community-based older adult care services to provide a basis for optimizing the older adult care service system.
A two-stage sampling method was employed to select older participants. Questionnaires, designed based on the Kano model, were administered to participants, and semi-structured interviews were conducted with community senior center managers and services users. The Kano model, Better-Worse index analysis and Analytic Hierarchy Process (Kano-BW-AHP) was used for quantitative analysis, while the two-step cluster analysis was employed for user profiles. Qualitative analysis was based on interview data.
A total of 259 questionnaires and 16 interview reports were collected. The Kano analysis identified 34 community older adult services, with most categorized as attractive or indifferent attributes, and only emergency assistance was identified as a one-dimensional attribute. The BW analysis revealed 3 must-be, 9 attractive, and 1 one-dimensional service. The top five services, based on the Kano-BW-AHP model, were contact with friends and relatives, emergency assistance, regular medical checkups, older adult canteen and meal delivery, and special policy consultation. A comparison between those who chose community-based older adult care and those who did not showed statistically significant differences in six variables: age, education, employee medical insurance, a regular pension, living status, and services awareness ( < 0.05). Cluster analysis of participants who chose community older adult care revealed two user profiles: 51 (73.9%) were urban, high-educated users with strong consumption willingness; 18 (26.1%) were rural, low-education individuals with limited income. Community older adult care centers face issues included limited service variety, inadequate beds, insufficient staffing, lack of funding, and no follow-up plans. Additionally, the older adult displayed limited understanding of care services, dissatisfaction with catering, and demand for spiritual support.
The community-based older adult care system shows a structural imbalance between supply and demand, particularly in terms of service quantity, quality, and efficiency. The findings provides a reference for policy formulation and the improvement of community-based older adult care services.
以中国西南部某城市地区为例，本研究对社区老年人护理服务的供需情况进行调查与分析，为优化老年人护理服务体系提供依据。
采用两阶段抽样方法选取老年参与者。基于卡诺模型设计问卷对参与者进行调查，并对社区老年中心管理人员和服务使用者进行半结构化访谈。运用卡诺模型、优劣指数分析和层次分析法（Kano - BW - AHP）进行定量分析，采用两步聚类分析确定用户特征。定性分析基于访谈数据。
共收集到259份问卷和16份访谈报告。卡诺分析确定了34项社区老年人服务，其中大部分被归类为魅力型或无差异属性，只有紧急援助被确定为一维属性。优劣分析揭示了3项必备服务、9项魅力型服务和1项一维服务。基于Kano - BW - AHP模型，排名前五的服务分别是与亲朋好友联系、紧急援助、定期体检、老年食堂及送餐服务以及特殊政策咨询。选择社区老年人护理服务者与未选择者在年龄、教育程度、职工医疗保险、固定养老金、生活状况和服务意识这六个变量上存在统计学显著差异（<0.05）。对选择社区老年人护理服务的参与者进行聚类分析，发现了两类用户特征：51人（73.9%）为城市高学历用户，消费意愿强烈；18人（26.1%）为农村低学历、收入有限的个体。社区老年人护理中心面临的问题包括服务种类有限、床位不足、人员配备不足、资金短缺以及缺乏后续计划。此外，老年人对护理服务的了解有限，对餐饮不满意，且有精神支持需求。
社区老年人护理体系在供需方面存在结构性失衡，尤其是在服务数量、质量和效率方面。研究结果为政策制定和社区老年人护理服务的改善提供了参考。
