Research On The Status Of Supply And Demand Of Aged Health Service Among Communities In F Main Urban Areas Of Guiyang

Objective: To survey and analysis elderly health services among communities and utlization and demand of the elderly residents.Knowing about the status of supply and demand of Aged Health Service of main city in Gui Yang,to provide the scientific evidence for primary health care institution to develop the aged health service in the furture. Methods: General survey was used to obtain 25 community health services(CHS) to understand the status and the current situation of health service for the elderly of the instutitions from the directors through questionnaire investigation and depth interviews.Stratified random sampling was used to get 110 staffs to investigate the status about the work of health service for the elderly through the questionnaire survey. In a typical community, First, get Yun Yan district from Gui Yang and get a community by simple random sampling, then used stratified random sampling to extracts three neighborhoods according to the distance of the community health service center. Results:(1) The community health service center in the main city is undertook by government or governmental hospital, enterprise’s hospital and private organization. 25 community health service centers have 632 medical staffs that consist of 88 general practitioners and 158 clinicists, 48 traditional Chinese physicians, 17 public health doctors and 321 nurses, and none of psychological consultant.(2) 38.18% staff in the community health service center should be responsible for multi-post in the job and 31.82% staff’s monthly income is under 2000.(3) Both of 25 community health service center don’t develop the service about hospice care and nursing, 76% community health service center don’t set up nutrition service, 48% center don’t develop psychological instruction, 36% center don’t set up the service about community first aid and home visit, 24% center don’t develop the service about the guidance on sports exercise and community-based rehabilitation.(4) 12.73% staff in community health service center express veryterrific satisfaction for the job, 63.63% staff express quite satisfaction, 20.91% staff express dissatisfaction and 2.73% staff express very terrific dissatisfaction; 85.45% staff know community health service center developing service for older; 84% principals of center think about the elderly community health servive supply ability of the main factors is the government and policy.(6) The two-week prevalence rate of 509 older who liveed in community is 14.3%, chronic disease prevalence rate is 54.2%, two-week outpatient rate is 12.4%. The people with low monthly income have high prevalence rate, which was statistical significance(P≤0.05); The older with aged female, higher age, junior high school diploma or above have high prevalence rate, which was statistical significance(P≤0.05). The aged who lived alone and the aged with low monthly income have high outpatient rate, which was statistical significance(P≤0.05). High age people have low awareness rate for physical examination, chronic disease management and sport excise guidance, with statistical significance(P≤0.05), the aged with chronic disease have high awareness rate for chronic disease management and nutrition clinic, which was statistical significance(P≤0.05).(7) Community health service for aged, treatment of common diseases, prevent chronic disease, health file management, etc, have a low availability in the aged who had high degree of education and high income, which was statistical significance(P≤0.05). The people with chronic disease have a high availability for prevent chronic disease, chronic disease management, directions on using the medicines and food, which was statistical significance(P≤0.05).(8) Females need more directions on using medicines, nutrition, food than males, with statistical significance(P≤0.05); the low and middle aged need more health examination, health education service and guidance for sport excise, which was statistical significance(P≤0.05). The aged with high education have low demand on health service, which was statistical significance(P≤0.05).the aged who have low monthly income have low demand on community aid, prevent chronic disease, chronic disease management, home visit, but, the aged who have high monthly income have low demand on treatment of common disease, The first diagnosis and referral of the disease, health file management, health examination, community-based rehabilitation,directions on using medicines and health education and counsel, which was statistical significance(P≤0.05). The aged with chronic disease have high demand that the first diagnosis and referral of the disease, community aid, prevent chronic disease, chronic disease management, home visit, community-based rehabilitation, directions on using medicines and food, nutrition clinic, which was statistical significance(P≤0.05).(9) Logistic regression analysis shown, chronic disease, medical insurance applied to community health service center and knowing about health service are independent factors for utilizing of the aged health service at community. Conclusion: The status of health service for the elderly is not well in the main urban area of Gui Yang. The rate of awareness, utilization and needs in old people to community health service for the elderly is low. We should enhance the construction in community health service institution of its own,at the same time,we also should improve the institution function,and gradually consolidate preventive care and chronic disease prevention work. Meanwhile, we should strengthen the publicity of the aged health service in community and develop the service demanding in the aged and easily accepted by the aged, in addition,we also increase the project of medical insurance in the community and enhance the acceptability of the aged health service in community.