Gené J, Moliner C, Contel J C, Tintoré I, Villafàfila R, Schorlemmer C
Universitat de Barcelona, Departament de Medicina.
Gac Sanit. 1997 Sep-Oct;11(5):214-20. doi: 10.1016/s0213-9111(97)71300-1.
To assess the association between living arrangements (living alone, with company or in a nursing home) and the health status and the use of health and social services among the population over seventy with the purpose to help establishing health policies for the elderly.
A cross sectional survey was performed, interviewing a random sample of 110 institutionalised and 290 community elderly of Castelldefels. Subjects and carers answered the following questionnaires: health status self-perception (SF-36), level of autonomy (test de Barthel), anxiety and depression levels (HAD), cognitive deficit (Short Portable Mental Status Questionnaire), availability and use of housing facilities an social and health resources.
77.2% of the institutionalised, and 92% of those coming from the community answered the questionnaire. 60 lived alone, 208 accompanied and 85 in nursing homes. The 67% were women and those living alone (77 +/- 4.8 years), or with company (78.3 +/- 6.4 years) where younger than the institutionalised ones (83.1 +/- 6.9 years) (p < 0.01). Housing facilities was similar in the three groups, although those living in the community had a higher level of use. The proportion of handicapped grew progressively from those living alone, with company or in institutions (13.3%; 19.6%. 86.7%; p < 0.01), as well as the cognitive deficit (7.8%; 15.3%; 20.8%, p < 0.01). Every group had similar health status, only those living with the family experienced higher scores in the emotional role or social function (SF-36). Non institutionalised population received support from relatives, friends and primary care services. Those institutionalised received health care in a more intensive and selective way, and benefited from formal cares.
Nursing homes host the population with highest level of cognitive deficit and dependence. The need of increasing formal care in the community, in special to people living alone, and of reorienting health services towards elderly care has been identified.
评估居住安排（独居、有人陪伴或住在养老院）与70岁以上人群的健康状况以及健康和社会服务使用情况之间的关联，以帮助制定老年人健康政策。
进行了一项横断面调查，对Castelldefels的110名机构养老老人和290名社区老人进行随机抽样访谈。受试者和照料者回答了以下问卷：健康状况自我认知（SF - 36）、自主水平（巴氏指数测试）、焦虑和抑郁水平（医院焦虑抑郁量表）、认知缺陷（简易便携式精神状态问卷）、住房设施以及社会和健康资源的可得性与使用情况。
77.2%的机构养老老人和92%的社区老人回答了问卷。60人独居，208人有人陪伴，85人住在养老院。67%为女性，独居者（77±4.8岁）或有人陪伴者（78.3±6.4岁）比机构养老者（83.1±6.9岁）年轻（p<0.01）。三组的住房设施情况相似，不过社区居住者的使用水平更高。残疾比例从独居者、有人陪伴者到机构养老者逐渐增加（13.3%；19.6%；86.7%；p<0.01），认知缺陷比例也如此（7.8%；15.3%；20.8%，p<0.01）。每组的健康状况相似，只有与家人同住者在情感角色或社会功能（SF - 36）方面得分更高。非机构养老人群得到亲戚、朋友和初级保健服务的支持。机构养老者接受更密集、更有选择性的医疗护理，并受益于正规照料。
养老院收纳了认知缺陷和依赖程度最高的人群。已确定需要增加社区尤其是独居者的正规照料，并将卫生服务重新定位为老年护理。
