Investigation On The Health Status And The Demands Of Health Care Service Of The Family Model Of Integration Of Medical,Nursing,and Nourishing Life For The Elderly Lived In Communities In Hangzhou

Objective To investigate and evaluate health status and demand of health care for the elderly in the community of Hangzhou.To determine the content of the family model of integration of health care services for the elderly lived in the community of Hangzhou,laying the foundation for the development of the family model of integration of medical,nursing and nourishing life.Methods With the guidance of Orem self-care theory and Maslow's hierarchy of needs theory,based on the literature research,the interviews and observation of elderly in the community of Hangzhou was taken to realize the elderly's acknowledgement of integration of medical care and health services,and to explore their real service demands.Afterwards,Delphi method was used to seek experts' advice,and then determine the necessary,feasible and suitable family model integration of health care services in Hangzhou.According to the general principles of the investigation study,the demands assessment questionnaire of the family model of integration of health care services was compiled on the basis of the previous literature research and qualitative research.Finally,a questionnaire survey was conducted on the status of health and the demands the family model of integration of health care services of 210 elderly people aged over 60 years in Hangzhou,according to the Boston Health Research Institute's concise Health Questionnaire(SF-36)Chinese version and the activities of daily life(ADL)commonly used rating scale--Barthel index rating scale(BI).Results Qualitative research:?The elderly in the community required professional medical and nursing services.? The elderly with poor self-care ability required family bed service.? There were urgent needs of the family model of integration of health care services for the elderly in the community.Quantitative research:? The elderly in the community of Hangzhou live longer.In this survey,46.77%of the elderly aged over the age of 80 and 86%of the elderly had stable economic sources because of pension.?There was a high prevalence rate of chronic diseases in the population of the elderly in the community of Hangzhou,94.03%of the elderly had more than 2 kinds of diseases,and the activities of daily living decreased with the increase of age.The medical burden of Hangzhou was heavy.? There were strong demands for the family model of health care services for the elderly in the community of Hangzhou.The scores of health education and health management were higher than 4.5 points(4 points represents the need for the service,and 5 points represents the urgent need for the service),the score of total demand was higher than 4 points.The development of the family model of health care services in Hangzhou met the health needs of the elderly in the community of Hangzhou.?There were centralized and numerous demand on high technical general medical service for the elderly in the community of Hangzhou,86.1%of the elderly's score for general medical service were higher than 4 points(4 points represents the need for the service,and 5 points represents the urgent need for the service).?The awareness rate and recognition degree for two-way referral service for the elderly in the community of Hangzhou were low,15%of the elderly have not realized two-way referral services.?The elderly in the community of Hangzhou held an attitude of waiting and seeing on value-added services.The score of value-added services was 3.89 only points.?The main factors that affect the health status of the elderly were medical expenditures and average monthly income.?The main factors affecting the demand for the family model of health care services for the elderly in the community were age and quantity of diseases.?Health status of the elderly in the community of Hangzhou was negatively correlated with the demand of the family model of integration of health care services.Conclusion Most of the elderly in the community of Hangzhou have a stable source of income with a relatively and longer per capita lifespan.Therefore,the prevalence of chronic diseases is high and the medical burden is heavy in Hangzhou.The elderly in the community of Hangzhou have a strong demand on the family model of integration of health care services.The development of the family model of integration of health care services in Hangzhou is suitable for the health needs of the elderly lived in the community.Items that are suitable for developing the family model of integration of health care services for the elderly in the community by community health care service centers in Hangzhou include general medical services,health management,health education and eight other categories of 47 services.The investigation and assessment of health status and demand of the family model of integration of health care services for the elderly in the community of Hangzhou provide the basis for not only the research on the content of integration of medical care and health services for the elderly in the community of Hangzhou,but also for standardized development of the family model of health care services in Hangzhou.According to results of two part studies,the government should develop family type integration of medical care and health services forcefully to meet the diversified needs of health services for the elderly in the community,strengthening the training of professional skills and knowledge of community health care workers,increasing the number of general practitioners and community nurses,and improve the community health care providers' enthusiasm for home service.