Research On The Health Care Service Of The Migratory Elderly In Hainan Province

?Objective?To understand the health care service demands of the migratory elderly in Hainan Province and health care management situation in order to analyze the health care issues existing in pension industry of Hainan Province.Based on the demand-oriented concept and model to provide policy suggestion and thus to establish foundation for health care management model of the migratory elderly with Hainan characteristics and to promote the development of Hainan pension industry with a new pattern.?Methods?This study developed a self-edited questionnaire with a framework based on Z-R theory and combined with literature research.The Activity of Daily Living Scale and the questionnaire were used to investigate the health care service demands of 1216 migratory elderly in Hainan Province.A semi-structured interview was conducted with 7 manager in health service field in order to know the management situation in pension industry for migratory elderly.?Results?1.The age of migratory elderly in Hainan mainly range from 60 to 80,72.29% of them went through High school(secondary school)or higher.62.99% earn more than3000 yuan per month.85.44% have worked in enterprises,institutions and government.71.38% live without children's companionship.The number with chronic diseases is 80.43%.The score of functional daily self-care ability ranging from 12 to14 is 79.93%.2.Migratory elderly have various levels of demands for health care services,while the strongest demands are effective treatment 92.68% and cross-region medical insurance reimbursement 81.99%.3.Pearson correlation analysis shows that there is a positive correlation between the health care needs of the elderly and their daily self-care ability score(r =0.252,P <0.01).The results of Student's t test and single-factor variance analysis show that the living pattern,age,family income per capita,education level,and numbers of children in Hainan that each elderly has,has an difference on their total score of health care demands(P ? 0.05).The results of multiple stepwise regression analysis show that the health demand of migratory elderly is affected by the daily self-care ability,home ownership,education level,the number of children they have in Hainan,rental housing and living with children.4.Semi-structured interviews indicate even giving nurseries' comprehensive service,but due to insufficiency of facilities and human resources,communities are unable to secure emergency services,some pension apartments even cannot provide any health services.There is an imbalance between pension and health care in communities and nursery apartments.In addition,as the migratory elderly's residence is seasonal,the utilization of public resources in Hainan rises and falls accordingly,and the migration also causes interruption of health care management.?Conclusions?The migratory elderly demand high level of health services due to their migratory feature.Their strongest demands mainly lay on timely and effective treatment of sudden illness or aggravation,and cross-region medical insurance coordination.While the mostly needed emergency services are still unsecured,and the insurance barriers yet remain to be eliminated.Their demands for health care differ due to varieties in the number of their children living in Hainan,education level,family income,living pattern in Hainan of home ownership rental housing and living with children,and daily self-care ability.And the demands are affected by above factors.The levels of medical service resources for the elderly are not even.Generally nurseries can provide comprehensive health services,while the imbalance of healthcare and pension still exist among communities and pension apartments.In addition,due to the seasonal moving of the migratory elderly in Hainan,we witness a seasonal economy in Hainan as well as the disconnected health management issue of the elderly between two places.