| Research BackgroundChina's aging situation is grim,and the number of very elderly and the elderly who have lost their self-care ability has increased significantly.The elderly have a large base,the aging process is short but the development is fast,and the ageing of "old but not rich" condition have become the main feature of China's aging society.With the decline of the function of elderly population and the increase of susceptibility of the disease,chronic diseases have become the main disease which threaten their health.Due to the long-term refractory characteristics of chronic diseases,more and more elderly people need long-term care in China,and the issue of care has become the focus of society.At present,the providers of long-term care services for the elderly in China are mainly their spouses or children,and they mainly provide life care.With the increasing miniaturization of family size,the growth of number of only-child families,the prolonged life expectancy of the elderly,the demand for elderly long-term care have been increasing.ObjectivesThis study conducts a questionnaire survey of the elderly in Shandong Province to understand the long-term care service demand of elderly people in Shandong Province,to analyze the factors affecting their demand for long-term care services.In combination with the current status of long-term care services in China,this paper puts forward relevant countermeasures and suggestion,improve social security related policies,meet the demand of long-term nursing service for the elderly,improve the quality of life,and actively promote the construction process of "healthy aging" in China.Materials and MethodsData in this study was from the database of National Natural Science Foundation of China(71673169),which made use a multi-stage random sampling method according to the principle of economic efficiency.According to the level of social economic development and geographical location,samples was taken from the western,middle,and east of Shandong Province,and finally 5649 households was drawn,totaling of 7070 seniors.In this study,the elderly who chose home care was selected as the research object,with a total of 6,237 people.Survey tools include self-made questionnaires and existing scales.The self-made questionnaire included demographic sociological characteristics,economic status,physical health status,disease status,and personal lifestyle status.The existing scale include the ADL scale and the K10 scale.Data were analyzed by SPSS21.0 software,single factor analysis were conducted by using chi-square test,and multivariate analysis were conducted by using binary logistic regression.Main ResultsA total of 6237 elderly were investigated in this study,and female elderly account for 59.1%.The minimum age was 60 years old,the maximum age was 101 years old,the average age was 70±6.5 years old,the median age was 69 years old,and the proportion of 60 to 69 years old was the largest,reaching to 51.1%.Most of the elderly lived with their families,accounting for 62.2%.The overall level of education was low,the junior high school level of education only accounted for 24.4%.49.3%of respondents have demand for long-term care services.Most of the residents had residents' first-grade medical insurance or second-grade medical insurance,accounting for 58.6%and 23.6%respectively.In terms of economic status,the average annual income was 11,660,the average annual expenditure was 7360,39.3%of people had savings,and 4.7%of them had debts.As for physical health condition,69%of people suffered from chronic diseases,and 18.1%of them had been hospitalized in the past 12 months.The self-rated health status of the elderly was more optimistic,only 18.7%people thought they had poor or very poor health.In terms of personal lifestyle,83.5%of the elderly smoked,16.2%of the elderly drank alcohol,39.2%of the elderly did not exercise,87%of the elderly had completely normal daily living ability and 66.7%of them had good mental health.The results of univariate analysis showed that in terms of demographic characteristics,with the increasing of age,the demand for long-term care services of the elderly increased significantly(?2=54.783,P<0.001).There was a significant difference in the demand for long-term care services among the elderly with different employment status(?2=10.077,P=0.006).There was a significant difference in the long-term care service demand for elderly with different place of residence(?2=27.951,P<0.001),and the demand of long-term care services for the elderly with different medical insurance situations were different =19.399,P=0.001).In terms of socioeconomic characteristics,the demand of long-term care services for the elderly with different incomes are different(?2=22.786,P<0.001).The greater the expenditure,the higher the demand for long-term care services for the elderly at home(?2=65.812,P<0.001).There was a statistically significant difference in the demand for long-term care services among the elderly with different savings(?2=39.945,P<0.001).In terms of health status,the demand for long-term care services for elderly people with chronic diseases was significantly higher than those without chronic diseases.The long-term care service demand of the elderly with different self-related health were significantly different(?2=75.910,P<0.001).The long-term care service demand of the elderly with different daily activities were different(?2=15.569,P<0.001),and the long-term care service demand of the elderly with different mental health status were significantly different(?2=16.808,P=0.001).As for personal lifestyle,the demand for long-term care services of smokers was significantly higher than that of non-smokers(?2=4.624,P=0.032).As the frequency of exercise increasing,the demand for long-term care services of the elderly was significantly reduced(?2=12.588,P=0.002).The results of multivariate regression analysis showed that age,place of residence,health insurance participation,income,expenditure,savings,self-realted health,daily living ability,mental health,physical exercise had significant impact for the elderly Long-term care service demand(P<0.05).ConclusionThe results of this study indicate that the overall level of long-term care services for elderly people in Shandong Province is low.Factors such as age,place of residence,types of medical insurance,income,expenditure,savings,self-rated health,daily living ability,mental health,physical exercise were significantly associated with the long-term care service demand of the elderly at home.SuggestionIn response to the results of this study,the following suggestions are made:the government provides relevant legal and policy support to build a long-term care service system,so as to promote the development of long-term care services for the elderly.In the context of lack of pension resources,give priority to key populations with high demand for long-term care services,such as elderly people,chronically ill elderly,disabled/semi-disabled elderly.To develop a long-term care insurance system as one of the basic guarantees for the elderly.To establish a sound long-term care service team and provide high-quality long-term care services.To build an Internet + home care service platform. |
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