| BackgroundWith the rapid development of modern society,people's lifestyle and family structure have undergone significant changes.family size has gradually narrowed,family pension function has been significantly weakened,and China's gradual severe population aging situation,socialized pension is the development direction of China's geracomium,the geracomium has become a place for the elderly to live intensively.Due to the decline of the elderly's physical function and the decline of immunity,there is a great demand for medical services.In the large policy environment in which the state deepens the reform of the medical and health system and actively promotes the grading diagnosis and treatment system,this paper conducts research on the health status of elderly people in the geracomium,the needs of medical and health services and the willingness to seek medical treatment.ObjectivesThrough the questionnaire survey of the research subjects to study the willingness of the elderly and the influencing factors of the elderly in the urban geracomium in Kaifeng City,the willingness to seek medical treatment in this study includes whether the research subjects are sick after the disease Seek medical treatment,choose the timing of medical treatment,and the willingness to choose a medical institution,explore the causes of the problem,and then guide the elderly in the geracomium to scientifically and rationally seek medical treatment,improve the quality of life and health care of the elderly in the geracomium,and improve the utilization of health resources.Propose reasonable countermeasures and suggestions to provide a basis for the government to formulate and improve health policies.MethodsIn this study,a stratified cluster random sampling method was adopted.Within the five municipal districts of Kaifeng City,each large-scale geracomium was randomly selected in each jurisdiction(the larger-scale geracomium in this study refer to the number of elderly people who stayed in the year).There are 5 geracomium with more than 200 people.A questionnaire on the willingness of the elderly for self-care in the geracomium was selected,and 500 elderly people who met the inclusion criteria were surveyed in the selected geracomium.The research team distributed 500 questionnaires from March 2018 to September2018,and collected 486 questionnaires.After eliminating the invalid questionnaires,467 valid questionnaires were obtained.The effective questionnaire recovery rate was 93.4%.Data was created and double-recorded using EpiData3.1 software.Descriptive analysis,?~2 test,ordered multi-class logistic regression analysis and binary logistic regression analysis were performed by SPSS22.0 statistical software to analyze the data.P<0.05 was considered to be statistically significant.Results1.In the context of the current national and government policies to promote grading diagnosis and treatment,in order to further promote the grading diagnosis and treatment system among the research groups,and gradually guide the elderly in the geracomium to scientifically and rationally seek medical treatment,and to change the traditional medical concepts and habits,this paper classifies the elderly in the geracomium.The cognition of the diagnosis and treatment system and its influencing factors were studied.The results of the study showed that there were 262 people(56.1%)who did not know the graded diagnosis and treatment system,and 150(32.1%)who knew but did not understand it.Only 55 people(11.8%)who knew the graded diagnosis and treatment system;There were 190 people(40.7%)in the medical treatment system.It is not clear whether there are 130 people(27.8%)who should follow the graded medical treatment system,and 62 people(13.3%)who agree with the concept of graded diagnosis and treatment.The univariate analysis of the subject's cognition of the grading diagnosis and treatment system showed that the education level(P<0.001),pre-retirement occupation(P<0.001)and monthly average income(P<0.001)were statistically different from the cognition of the elderly patients'grading diagnosis and treatment system in the geracomium;The results of multivariate regression analysis showed that education level and pre-retirement occupation were the main factors affecting the cognition of hierarchical diagnosis and treatment system for the elderly in the geracomium.The subjects with higher education have higher cognition of hierarchical diagnosis and treatment.The subjects of the study,who were civil servants and medical workers before retirement,had a higher cognition of hierarchical diagnosis and treatment.2.The research results of the study participants'willingness to seek medical treatment showed that248(53.1%)were the first patients to be treated,150(32.1%)were treated when recurrent episodes,and 69(14.8%)were treated when the pain was unbearable.In the study of the subject's cognition of physical examination,the statistical results showed that 62.5%of the subjects had a positive attitude toward the physical examination,and it was considered necessary to conduct a physical examination,only 10.7%of the subjects had no awareness of the importance of the physical examination,and whether it was considered the medical examination does not matter.3.The single factor analysis of the willingness of the elderly to suffer from common mild illness in geracomium shows age(P<0.001),religious belief(P=0.003),marital status(P<0.001),type of insurance(P<0.001),chronic illness(P<0.001),pre-retirement occupation(P<0.001),monthly average income(P=0.003),daily funding source(P<0.001),and health self-evaluation status(P<0.001),the graded diagnosis and treatment cognition(P=0.012)and the average annual medical expenses(P<0.001)were statistically different from the willingness to seek medical treatment for the subjects with common minor illnesses.The statistically significant items in the univariate analysis were included in the two-category logistic regression analysis.Age,marital status,chronic illness,cognition of graded diagnosis and treatment system,pre-retirement occupation,daily funding source and type of insurance are the main factors affecting the willingness of medical practitioners to suffer from common minor illnesses;The willingness to choose focuses on the distance of medical treatment,personal habits,medical expenses,and medical insurance.4.The single factor analysis of the willingness of the elderly to suffer from major illnesses in the geracomium shows that age(P<0.001),education level(P<0.001),marital status(P<0.001),type of insurance(P<0.001),chronic illness(P<0.001),pre-retirement occupation(P<0.001),monthly average income(P<0.001),grading diagnosis and treatmentcognition(P=0.012),health self-evaluation(P<0.001)and the average annual medical expenses(P<0.001)were statisticallydifferent from the willingness to seek medical treatment for the subjects with major diseases.The statistically significant items in the univariate analysis were included in the results of the two-category logistic regression analysis.Age,education level,pre-retirement occupation The cognition of the graded diagnosis and treatment system is the main factor affecting the willingness of the research subjects to seek medical treatment when they have major diseases.The researcher's willingness to choose a medical institution is focused on personal habits,diagnosis and treatment,medical insurance,and medical treatment.5.When the subject is sick,the research subjects pay more attention to the doctor's clinical experience,social reputation and professional title level;the research object believes that the main reason for the current medical difficulties is the cumbersome medical treatment process,the lower proportion of medical insurance reimbursement,the high medical expenses and the expert number;The research object believes that the main problems that medical institutions should solve now are to improve medical standards,reduce medical procedures,and improve medical ethics.Conclusions1.The willingness of the elderly to seek medical treatment in the geracomium is affected by factors such as age,marital status,education level,chronic illness,pre-retirement occupation,monthly average income,self-evaluation of health,cognition of graded diagnosis and treatment system,distance of medical treatment,and personal habits.2.When the subjects were suffering from common mild diseases,age,marital status,chronic illness,cognition of graded diagnosis and treatment system,pre-retirement occupation,daily funding source and type of participation were the main factors affecting the willingness of medical practitioners to suffer from common minor illnesses.When the study subjects suffer from common mild diseases,the choice of medical institutions is focused on medical treatment distance,personal habits,medical expenses,and medical insurance.3.When suffering from major diseases,age,education level,pre-retirement occupation,and grading diagnosis and treatment system cognition are the main factors affecting the willingness of the research subjects to seek medical treatment for major diseases.When the subject suffers from a major illness,the willingness to choose a medical institution focuses on personal habits,diagnosis and treatment,medical insurance,and medical treatment.4.The subjects'cognitive status to the graded diagnosis and treatment system was poor.The education level and pre-retirement occupation were the main factors affecting the classification and diagnosis of the subjects.Suggestions1.The government and the health department strengthen the propaganda of the grading diagnosis and treatment system,strengthen the concept of medical treatment for the elderly.2.The government strengthen the macro-control and rational allocation of medical and health resources,pay attention to the training of grassroots health personnel,and improve the ability of health services in primary health care institutions.3.Medical institutions strengthen the construction of humanistic care for the elderly in geracomium,and improve the medical treatment of the elderly in geracomium.4.Integrating medical insurance with medical assistance,improving the construction of medical security system,and improving the coverage of people enjoying medical insurance. |
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