| BACKGROUNDAs population aging, the retired cadres are entering the high-morbidity period, which is directly related with the severe health problem, medical issues as well as low quality of life. Because of their contribution to national revolution and construction, retired cadres are treated as national heroes and scarce human resources. So, the Communist Party and government have always attached great importance to those veterans, who are required to be concerned and taken care of carefully by all related organizations. And the medical services and heath care is one of the most important contents of retired cadres.Since 2003, the Hongkou district health bureau has been exploring the new models of Veteran health care as a pilot area. After several years of exploration, we are aware that the development of the medical direction of veteran's health care is sinking into the community. The new model is focus on the community health services networks, which is effectively relied on by basic medical care, preventive care, rehabilitation and health education services.However, a targeted system research on demand and use of health services of retired cadres groups living in city community is still lack of, which is essential for the establishment of retired cadres in our health care community management mode.OBJECTIVEBased on the health services needs of retired cadres, systematically analyzing the factors influencing their health services utilization, and provide some suggestions and recommendations for improving health services of retired cadres.METHODS1. For retired cadres survey:take hierarchical cluster random sampling method, one-to-one in door questionnaire.2. For healthcare staff:take the form of group interviews, qualitative research.RESULT1.1576 retired cadres were investigated in Hongkou district. Their characteristics as follows:primarily older, more male, higher educated, poorer self-care;,physical suffering from a variety of chronic illnesses that require long-term treatment, and psychological state of depression or anxiety were common.2. The two-week prevalence of investigated retired cadres was 37.4%, chronic disease prevalence was 87.1%, two weeks visiting rate was 85.2%, hospitalization rate for one year was 34.2%, diagnosis and treatment of chronic diseases were key measures to control health services demandof retired cadres.3. Multivariate statistical analysis results showed that prevalence and incidence of chronic disease was a key factor influencing the health services demands of retired cadres. For example, the two-week prevalence of them was increasing with the incidence of chronic disease. And those retired cadres who educated less than primary school, smoking, alcohol consumption for more than 3 times per week, and suffering from more chronic disease were apt to been hospitalised in the past year.4. After years of exploration, Hongkou district has strengthened the establishment of city retired cadres community health services in the network, which the basic health care, preventive care, rehabilitation and health education services has relied on. The retired cadres preferred to visit community health service center when sick.SUGGESTION1. Health care services of retired cadres should focus on the treatment of chronic and non-communicable diseases, and providing the community-based disease prevention, health care, rehabilitation and health education. Accordingly, we suggestion the government to perfect the functionality and scale of community health centers, especially in the aspects of personnel disposition and funding invested and so on.2. Establishing the new quaternate general practitioner service team model with general practitioners, community nurses, public health doctor and health social workers. The services of health social workers focus on psyehology guidance. General practitioners and public health doctor provide the medical services which combines the prevention of health with the clinical therapy.3. According to the different age, different knowledge levels and different status of illness, providing personalized therapy projects, such as providing "family bed" for those suffering from a variety of chronic illnesses that require long-term treatment.4. Establishing and perfecting the personal health records of retired cadres, detailed grasping their basic and major health conditions, strengthening the dynamic health information management by interview, and establishing a internet-based informationization management system to sharing the healthy files at different levels of medical institutions, in order to lay "two-way referral" a solid foundation for benign interaction. |
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