Research On The Current Situation Of Integrated Medical And Nursing Care For The Elderly In Beijin

The accompanying elderly are a group of elderly who are wandering in strange cities.They often stay away from their hometown in order to support their children’s careers and take care of their grandchildren.They not only have to bear the burden of taking care of their families and face intergenerational conflicts but also adapt to the unfamiliar urban living environment.Medical treatment,old-age care,and nursing are three complementary and inseparable elements in healthy old-age care.However,there are few studies on these three aspects of the migrant elderly.This study takes this as the starting point to explore the basic situation of the migrant elderly in Beijing and provide reasonable suggestions for the balanced allocation of pension resources.Objective:This study hopes to understand the health and elderly care needs of the urban elderly,from the perspective of medical treatment,elderly care,and nursing,to have an in-depth understanding of the current situation of elderly care in Beijing,in order to enrich the research on the current situation of the elderly care in urban areas,and put forward targeted suggestions for the management of the urban elderly in the community,so as to improve the health level of the elderly in their later years.Methods:(1)Literature research method.Through literature research,select the independent variables that affect the satisfaction of medical care,and provide the basic theory for the three perspectives of medical care.(2)Descriptive statistical analysis.In this study,descriptive statistical analysis was conducted on the collected quantitative data to roughly understand the main problems and current situation of the elderly in Beijing in the three aspects of medical care,elderly care,and nursing.(3)Grounded theory analysis method.The interview notes of the survey were "decoded" word by word,the data from in-depth interviews were decomposed and simplified,and the influencing factors of the satisfaction of the elderly with medical care were analyzed.(4)Multivariate analysis.Through the method of multiple logistic regression analysis,this paper explores the use and satisfaction of the elderly in Beijing with the integration of medical care and maintenance.Results:The results of descriptive statistical analysis show that only 35.5%of the accompanying elderly believe that their situation is relatively good or better;81.58%of the accompanying elderly put their health needs in the first place;81.85%of the elderly in Beijing have a monthly income of more than 2000 yuan;In terms of medical services,56.6%of the accompanying elderly went to the community health service center to see a doctor;64.5%of the accompanying elderly did not sign a family doctor;Only 6%of the accompanying elderly have known about the two-way referral service.30.26%of the accompanying elderly believe that medical expenses are a heavy burden for them,and these elderly believe that medical reimbursement is important or very important.In terms of elderly care services,94.73%of the accompanying elderly choose family elderly care and 5.62%choose home-based elderly care.In the survey,it has not been found that any accompanying elderly choose to provide for the elderly in professional institutions.Without considering the actual situation,28.95%of the accompanying elderly are still willing to choose the community home-based elderly care model,9.21%of the accompanying elderly are willing to go to elderly care institutions for elderly care,but 61.84%of the accompanying elderly still choose family elderly care,and 94.74%of the accompanying elderly do not know the elderly care services and facilities provided in the community;During the survey,no accompanying elderly people are limited in terms of bus travel or park travel.In terms of nursing services,53.95%of the accompanying elderly did not know much about nursing knowledge;Most of the accompanying elderly still take care of themselves more and mainly take care of their spouses and children.61.84%of the accompanying elderly are willing to spend less than 1000 yuan on hiring nannies.The main research results of grounded theory are as follows:(1)in tems of the restrictive factors of medical services,most of the accompanying elderly are dissatisfied with the restrictive factors of medical services,which is mainly due to the difficulty of medical insurance reimbursement in other places,which makes them spend more on medical services.(2)At the level of elderly care services,most of the accompanying elderly spend their time taking care of their younger generation and lack communication and contact with the outside world.Their actual utilization of community elderly care resources is relatively low.Therefore,the elderly often feel lonely and embarrassed or inferior because others don’t understand dialects in life and shopping.(3)In terms of nursing services,although most of the accompanying elderly have certain needs for professional nursing services,there are a large number of nursing service needs that have not been transformed into nursing service needs.(4)In terms of the gap between the ideal pension state,the current accompanying elderly are affected by their own economic situation,and there is a certain gap between the ideal pension service mode and their own actual situation.Although some accompanying elderly people are not satisfied with medical care,they have a psychological "capital effect" and are satisfied with their personal life.The results of multiple logistic regression showed that the biggest influencing factor on the satisfaction of the elderly with medical care was the medical service.In terms of the importance of medical insurance,there is no multiple odds ratio relationship on medical maintenance satisfaction;In the influence of medical expense burden on medical maintenance satisfaction,the odds ratios of dissatisfaction,general satisfaction,and very satisfied are 0.05 times,0.02 times and 0.11 times;In the influence of family doctor’s satisfaction on medical care satisfaction,the odds ratios of dissatisfaction,general satisfaction and very satisfied are 0.24 times,0.80 times and 0.10 times;In the influence of two-way referral satisfaction on medical care satisfaction,the odds ratios of dissatisfaction,general satisfaction and very satisfied were 2.34 times,426.07 times and 3.81 times;In the influence of satisfaction of community medical institutions on the satisfaction of medical care,the odds ratios of dissatisfaction,general satisfaction and very satisfied are 21.22 times,0.05 times and 2.11 times.In the influence of family relationships on the satisfaction of medical care,the odds ratios of dissatisfaction,general satisfaction,and very satisfaction were 16.8 billion times,28 billion times,and 313.5 billion times;Among the effects of community day care and home care on medical care satisfaction,the odds ratios of dissatisfaction,general satisfaction and very satisfied are 0.00 times,0.42 times and 0.50 times;There is no significant difference among dissatisfied,average and very satisfied.In terms of nursing service,there was no multiple odds ratio relationship between nursing knowledge awareness and medical care satisfaction;In the influence of others’care satisfaction on medical care satisfaction,there was no significant difference among dissatisfied,average,and very satisfied.Conclusions:(1)The biggest need of the elderly with migration is their health needs.The health status of the accompanying elderly will affect their personal well-being,and promoting the healthy aging of the accompanying elderly is conducive to family and social harmony.(2)The main social problem of the elderly who move with them is the reimbursement of medical treatment in other places.Most regions in China adopt the advance payment system for medical reimbursement,and the extra round-trip travel and accommodation costs increase the economic pressure on the elderly.(3)The elderly who move with them make little use of grass-roots public health services.Most of the accompanying elderly do not make high use of primary health services,and some of them are even willing to buy drugs across regions.(4)The elderly who move with them make insufficient use of pension service resources.Due to the differences in language and living habits,the elderly who move with them do not make full use of the elderly care facilities and gyms in the community,and the construction of software and hardware in the community does not adapt to the development trend of aging.(5)The elderly who move with them make less use of nursing services.Because they are in the state of providing for the aged in different places,most of the elderly who move with them believe that the consumption level in Beijing is too high.Coupled with the regional differences in pensions,they tend to choose an economical way of providing for the aged at home,and the utilization rate of professional nursing services is extremely low.Discussion and limitations:In this study,the living conditions of the elderly in their later years are studied from the perspectives of medical treatment,pension,and nursing.Compared with the previous studies on the elderly,more in-depth and extensive exploration is carried out,which not only enriches the relevant research on the pension status of the urban elderly but also provides reference for the management of the urban elderly.However,due to the impact of the epidemic situation and other factors,this study can only select Chaoyang District and Haidian District in Beijing for random investigation.However,the economic level of these two districts is good,and there is no investigation of the elderly who move a little behind in the economy.Therefore,the sample data in this paper have certain limitations.Moreover,the data sample size is small,so the results may not be robust enough.However,considering that the actual utilization rate of medical care for the elderly who move with them is less,and the results are somewhat interpretable,they are still displayed.In the follow-up study,we should expand the sample data and further strengthen the research,including adopting PPS sampling and other methods to make the sample more representative as far as possible;Typical surveys in some areas can be carried out to enhance the accuracy of data and results;It is suggested that the government and relevant departments should strengthen the collection and statistics of the relevant data of the migrant elderly to form a richer statistical data system for the migrant elderly.