The Research On The Influencing Factors Of Rural Elderly’s Health

BackgroundWith the deepening of the aging population, some political, economic and social problems are rising, the issues in rural areas have also been put on the agenda. The reform of health care, security and other aspects of social life is needed. In recent years, during the process of health care reform, some special programs were carried out with the basic public health services items were issued. Meanwhile the discount reimbursements of clinic service for the elderly were introduced in some place. In order to achieve the goal of the basic public health services equalization in the process of health care reform, the policy maker need to know the health status and health needs of the elderly in rural areas and think about how to provide appropriate services for them. From an international perspective, there are many studies on the health services for the elderly. Chinese scholars have done some research in this area, however, most of those studies are limited in one aspect, or more focused on geriatric clinical services. The empirical research on the sociological factors which affect the health status of the elderly and preventive care is still rare. Objective analysis of the health status and health needs of the elderly in rural areas, connected with the public service, is very necessary and useful to improve services for the elderly in the new situation.ObjectiveThe research aimed to analysis the potential gap between demand and services supply of rural elderly based on the health status and health needs of the elderly and health service utilization, find the system defects and make policy recommendations, provides the evidence on improving the elderly health services capabilities and elderly health insurance system.Research methods and contentIn this research the field survey, case interviews and policy analysis methods are adopted. Samples are decided by stratified random method. The overall representativeness of the sample is good. The database was build. The statistical analysis of descriptive analysis, t test, Wilcox test, is used in the analysis of sociological characteristics, health status, and health care utilization by SPSS 18.0 and EXCEL. The disease burden and its factors were analyzed by multivariate analysis. Policy effects are analyzed by Difference-in-Difference.(1) Sociodemographic characteristics of the rural elderly. Rural elderly population structure, economic status, social and cultural characteristics, and basic health care situation were included.(2) Rural elderly health status and mental health. Self-care ability, the chronic illness, the caregiver as well as loneliness were described.(3) Rural Elderly disease burden and its influencing factors. The clinic fees, hospital costs and socioeconomic factors were analyzed.(4) The preliminary assessment of the effect of free anti-hypertensive drug policy. Awareness of the policy of the elderly, treatment and medical expenses was analyzed. Selected a control area for comparative analysis.The main results(1) Chronic diseases are the main factors affecting the economic burden of the disease for rural elderly. In the rural elderly surveyed those who can take care of themselves accounted 76.47%. The main factors affecting the activities of daily living, including age, no spouse, low income, chronic disease. The elderly with chronic diseases accounted for 76.90%. Wherein the proportion of people with cardiovascular disease was 70.07%, the proportion of people with motor system disorders was 17.13%, with two kinds or more diseases accounted for 41.18%.(2) Mental health of rural elderly needs attention. The elderly who feel the lonely accounted for i 27.25%. For the elderly, the factors that affect the mental health and result in loneliness include living by themselves and no solitary companion, less family member visiting, no opportunity to participate in community activities.(3) The disease if heavy burden for rural elderly, the current health insurance system has deficiencies in reducing the disease burden. Consumer spending accounts for health care spending is relatively high. The main medical cost is paid by themselves and their children. China’s basic medical insurance and medical aid are highlighted with serious co-ordination based, which had missed the growing epidemic of chronic diseases of the status quo.(4) The anti hypertensive drug free policy in Rushan has some positive effects. It is suggested to be arranged as a long-term system.36.8% of the hypertensive elderly to take the free drugs. The impact of the policy on low-income groups is significant.Policy recommendations(1)Develop healthy aging strategies. Improve rural elderly health services, combined health services into long-term care to adapt to the characteristics of the elderly chronic disease. Based on the public health services, popularize and standardize the prevention and treatment of elderly patients with non-communicable chronic diseases.(2)Develop various forms of rural elderly mental health service system. The mental health training should be conducted for village doctors and the pension agency staff. The relative institution can provide appropriate psychological counseling and intervention. In order to enrich the cultural life of the rural elderly, a variety of groups or associations for the elderly should be encouraged.(3)Better the health insurance and medical aid system design. Medical insurance system should be tilted vulnerable populations and cover the cost of disease prevention services. Consideration should be given to low-income elderly people with special medical relief, and part of the maintenance therapy to non-communicable chronic diseases with high cost-effective.