| [Objective] To find out the current development situation and problems of home-based care for the aged and it’s aware of the situation, willingness and demand of the services from community people at Guandu District of Kunming city. Meanwhile analysis the influencing factors of home-based care for the aged, obtain the status of home-based care for the aged at Guandu District of Kunming city, in order to make recommendations for the development of home-based care for the aged and provide the scientific basis for the policy’s formulation for the related departments.[Methods] This study was cross-sectional study. The respondents were the over50years old residents, who lived at Tangshuang community and Yiyuan community of Guandu District Kunmingcity between2012.12.17to2012.12.21. The study made a survey to the residents with the random sampling method. At the same time there was also an interview to the staffs of the Kunming civil affairs. At the end, the corresponding data was imported with Epidata,and analysised with SPSS.[Results]1. Demographic characteristics:There were827respondents in this research,313men, accounted for37.85%,514women, accounted for62.15%;788Han people, accounted for95.28%,39minority people, accounted for4.72%;689married people, accounted for83.31%,138unmarried, divorced and widowed people, accounted for16.69%;316primary school and below316people,237junior high school people,187high school or technical secondary school people,87college and above people, accounted for38.21%,28.66%,22.61%and10.52%;47people’s income below1000yuan a month, accounted for5.68%,64people’s income between1000～1500yuan a month, accounted for7.74%,368people’s income between1500～2000yuan a month, accounted for44.50%,348people’s income more than2000yuan a month, accounted for42.08%;47people living alone, accounted for5.68%,780people living with families, accounted for94.32%.2. The condition of medicare:724people had medicare, accounted for87.55%,103people din’thave medicare, accounted for12.45%.3. The condition of self-care ability:657people had self-care ability, accounted for79.44%,170people din’t have self-care ability, accounted for20.56%.4. Awareness of home-based care for the aged and its’influencing factors:252people knew home-based care for the aged, the awareness rate was30.47%.Logistic single factor analysis showed that the influencing factors of the awareness rate of home-based care for the aged were education (OR=2.47),income (OR=2.16) and self-care ability (OR=1.72).Logistic multi factor regression analysis showed that the influencing factors of the awareness rate of home-based care for the aged were education (OR=2.31),income (OR=1.84) and self-care ability (OR=1.68). Meanwhile,it was found that the major channel of awareness was media as TV or newspaper(accounted for84.80%),lack of government’s publicity(only accounted for2.94%).5. The service willingness of home-based care for the aged:654people accepted the service of home-based care for the aged,the receptance was79.08%.Spearman rank correlation analysis showed that it was positive correlation(r=0.19) between awareness and service willingness. Meanwhile,it was found that there were100people who refuse the service because of believing they can take care of themselves or be taken care by families, accounted for57.80%in173people.6. The condition of service needs of home-based care for the aged and its’ influencing factors:In the654people who accepted the service of home-based care for the aged,there were450people who had the service needs of home-based care for the aged, the demand rate was68.81%. Logistic single factor analysis showed that the influencing factors of the service needs of home-based care for the aged were medicare (OR=2.60) and income (OR=2.45).Logistic multi factor regression analysis showed that the influencing factors of the medicare of home-based care for the aged were medicare (OR=2.51) and income (OR=2.24).7. The condition of layered service needs of home-based care for the aged and its’ influencing factors7.1The condition of physical service needs and its’ influencing factors:In the450people who had the service needs of home-based care for the aged,there were390people who had the physical service needs, the demand rate was86.67%. Logistic single factor analysis showed that the influencing factors of the physical service needs were gender(OR=2.60),education(OR=1.54), medicare (OR=2.24),income (OR=1.93) and self-care ability(OR=0.74). Logistic multi factor regression analysis showed that the influencing factors of the physical service needs were gender(OR=1.86),education(OR=1.53), medicare (OR=1.97),income (OR=1.74) and self-care ability(OR=0.68).7.2The condition of security service needs and its’ influencing factors:In the450people who had the service needs of home-based care for the aged,there were320people who had the security service needs, the demand rate was71.11%. Logistic single factor analysis showed that the influencing factors of the security service needs were gender(OR=1.66),age(OR=1.12), medicare (OR=2.67) and self-care ability(OR=0.53). Logistic multi factor regression analysis showed that the influencing factors of the security service needs was medicare (OR=2.50).7.3The condition of attribution and love service needs and its’ influencing factors:In the450people who had the service needs of home-based care for the aged,there were154people who had the attribution and love service needs, the demand rate was34.22%. Logistic single factor analysis showed that the influencing factors of the attribution and love service needs were gender(OR=1.59),age(OR=0.97), medicare (OR=1.84) and resident manner (OR=0.73). Logistic multi factor regression analysis showed that the influencing factors of the attribution and love service needs were age(OR=0.97), medicare (OR=1.76) and resident manner (OR=0.61). 7.4The condition of respect needs and its’influencing factors:In the450people who had the service needs of home-based care for the aged,there were169people who had the respect service needs, the demand rate was37.56%. Logistic single factor analysis showed that the influencing factors of the respect service needs were age(OR=0.96), education(OR=1.50),medicare (OR=2.24) and self-care ability(OR=2.17). Logistic multi factor regression analysis showed that the influencing factors of the respect service needs were age(OR=0.97), education(OR=1.45) and medicare (OR=2.27).7.5The condition of self-realization needs and its’influencing factors:In the450people who had the service needs of home-based care for the aged,there were216people who had the self-realization service needs, the demand rate was48.00%. Logistic single factor analysis showed that the influencing factors of the self-realization service needs were age(OR=0.96), education(OR=1.63),medicare (OR=1.74) and self-care ability(OR=2.37). Logistic multi factor regression analysis showed that the influencing factors of the self-realization service needs were age(OR=0.97), education(OR=1.61),medicare (OR=1.61) and self-care ability(OR=1.80).8. The interview resuIt:There were50communities in Guandu district of Kunming,and only9communities had developed the home-based care for the aged service.The service rate was18.00%.The service objects were the residents who were older than60years.The major service content was daily care. Most service personnel were full-time,who had be trained unstandardly. The service utilization rate was very high. Main service charges were low compensation. At the present stage,there were4problems in the development of home-based care for the aged service.First, The policy was not in place, lack of guidance about home-based care for the aged.Second,government’investment was not enough.Thirdly, the infrastructures of most communities were not perfect.Fourthly, service personnel were not enough.[Conclusions] At present, the laws and regulations about the home-based care for the aged at Guandu District Kunming city are not yet in place.The shortage problem of government funding is very seriously. The integration of community resources and infrastructure are not perfect.The contents of home-based care for the aged are not diversified.It is lack of service personnel,and the professionalism is too low. The awareness’s rate and way of home-based care for the aged survey are very low and simple to the residents.The new concept of pension are not yet formed.Raising awareness is helpful to improve the service willingness.Physical service and security service demand rate is high,the income and medicare status are the key factors to the demand of home-based care for the aged.Meanwhile the kinds of home-based care for the aged service should be varies to different people.[Suggestions] At the policy level, government should improve relevant laws and regulations, formulate the development plan for home-based care for the aged, increase financial input with broaden the financing channels. At the operations level, the community should effectively integrate the community resources, strengthen the infrastructure construction and service personnel building. At the service utilization party level, it should increase the publicity and promotion for the new pension conceptions, raise the awareness ratio, improve the demand for home-based care for the aged though the multi-service costs and health insurance, focus on the basic services in work, at the same time make the service contents richness, provide the differentiated services due to the different demands. |
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