Stduy On The Long-term Care Service Model And Its Operational Mechanism Of Community Disabled Elderly People Based On The Day Care Center

Along with the advancement of global aging,the relevant trend has been strengthened constantly in our country.It is shown that our country has entered the aging society and about half of old men suffer from the high blood pressure,the coronary heart disease and other chronic diseases,with the data of the sixth national census in the national bureau of statistics.Due to the continuous improvement of medical and health level,many diseases can be controlled after acute treatment without restored original functions,which will improve the number of disabled elderly people.In addition,elderly people will need more and more long-term care services because of the change of social form and the transformation of family structure in the future.The concept of aging in place prevails in the world,providing a new solution for long-term care problems as an important way to cope with the aging trend around the world.In recent years,our country strongly advocates the service system taking the home pension as foundation,the community service as support,as well as the institutional pension as supplement.The construction of the day care center for community elderly people intensively reflects the implementation of pension services based on community services,making half-disabled elderly people live in their own families and communities,and it relies on community resources to meet care demands.This research is mainly divided into three parts:The first part: the study on the status quo of care services for community disabled elderly peopleFirstly,this paper makes an inventory survey on disabled elderly people's utilization of health care resources.It understands disabled elderly people's utilization of health care resources with the questionnaire survey,and it analyzes influence factors of the utilization of health care resources with the logistic multivariate regression.The results show that:(1)main influence factors of the two-week consultation rate for community disabled elderly people are the culture degree,the monthly per capita income of family,the health care and the number of chronic diseases.(2)Main influence factors of the one-year hospitalization rate for community disabled elderly people are the culture degree,the marital status,the monthly per capita income of family and the health care.(3)A big utilization space exists among elderly people for the community health service;disabled elderly people have a higher consultation rate.And 64.9% of disabled elderly people didn't go to see a doctor with consultation intention in the past two weeks.And disabled elderly people have a lower utilization rate of institutional care,whose demands haven't been met by hospital services.In addition,100% of disabled elderly people all deny institutional care.56.8% of disabled elderly people think care and treatment in other forms are needed except for hospital outpatient services.52.8 of elderly people cannot understand services from the community day care center well and are willing to accept relevant services after elaboration.What's more,100% of hospitals don't arrange care for elderly people after hospital discharge,and 90.5% elderly people say that they will accept arrangement if have.Secondly,this paper understands the utilization status and service willingness of relevant people's long-term care services based on the day care center,using a semi-structured in-depth interview method.The interviewed people include 5 community disabled elderly people,5 main caregivers,3 staff from the community health service center and 3 staff from the care centre.There are 4 extracted topics,including 1 the service are not perfected provided by the day care center;2 disabled elderly people and caregivers desire for continuous care in health care and life;3 various factors will influence the cooperation between the day care center and the community health service center;4 the cooperation service willingness emphasizes different aspects between the day care center and the community health service center.The second part: the service model is constructed for the community disabled elderly people's long-term care based on the day care center,with previous research results.The model mainly includes seven aspects: 1 purpose;2 the general principle;3 the role functions of community service organizations are provided;4 the overall operational path;5 the evaluation tool of service supervision and assessment;6 the service content of long-term care services;7 the advice on ensuring continuous long-term care services.The third part: taking mild and moderate disabled elderly people in Taian City as examples,this paper discusses the operational mechanism of the service model for the community disabled elderly people's long-term care based on the day care center.The care process can be divided into the acute medical period,the chronic medical period,the care-search period and the end-care period.At the same time,the model operation should reflect characteristics of the whole people,community,continuity and the specialization.In essence,the theory construction of the service model for the community disabled elderly people's long-term care is to realize a seamless connection from the long-term care of hospital and discharge to the long-term care of home,community and institution.The model can meet care demands from elderly people and their caregivers,and improve the utilization of community resources with the best care quality,the less waste of medical resources and a great significance for elderly people's long-term care.