Research On Demand-based Regional Cooperative Medical Care Combined With Home Nursing Care Model

Objective:To build a regional collaborative medical-nursing combined health management platform on the basis of fully understanding the current situation of home care needs of the elderly in the community.Relying on the platform,we are going to explore a regional collaborative medical care combined with home nursing care model,and provide quality and efficient medical care combined with home nursing care services,finally to improve the quality of life,health self-management skill and satisfaction of the elderly,and provide reference for solving the pension problem in China at this stage.Methods:1.From July to August,2017,420 elderly people in Shenyang were selected by convenient sampling as research samples,and they were investigated with self-made“Community Elderly Home Care Demand Status Questionnaire”.2.To design a regional collaborative medical-nursing combined health management platform through the literature review method and the expert meeting method,and build the platform by network engineers.The platform was put into trial operation at Nanhu Community Health Service Center after establishment.The application of the platform and users' evaluation were investigated by telephone interview method,and the platform was improved according to the feedback.3.100 elderly people were each selected in two communities A and B of Nanhu Community Health Service Center by convenient sampling.After random grouping,the regional collaborative medical care combined with home nursing care model was adopted in the experimental group,and the regular community home care model was implemented in the control group.The research lasted6 months.The elderly of the two groups were investigated with the life quality scale,the health self-management ability assessment scale and the community home care service satisfaction questionnaire at baseline,after intervention for 3 months and 6 months,and the information collected was analyzed.SPSS20.0 was used for data entry and statistical analysis.The counting data were statistically described by frequency and percentage,the measurement data were statistically described by mean±standard deviation.The influence factors were analyzed by multiple linear regression.The differences between groups were compared by t test,one-way analysis of variance,chi-square test or non-parametric test.If P < 0.05,the difference was judged statistically significant.Results:1.The total score of home care needs of 410 community elders was(60.24±11.16),and the disease prevention score(11.95±1.74)was highest.The top five needs of home nursing care were disease prevention education,health consultation,regular physical examination,medication guidance and health records.The main influence factors of home nursing care needs in the elderly included illness status,age,income and expenditure,education,marital status and self-care ability.2.A regional collaborative medical-nursing combined health management platform was established,and it was composed of five modules: health records,follow-up plan,remote training,health education and remote consultation.The utilization rate of the platform was high(80.00%),and 81.25% of users had a high overall evaluation of the platform.3.At baseline,life quality,health self-management ability and home care satisfaction of the experimental group and the control group were low,and the differences between the two groups were not statistically significant(P>0.05).The differences in life quality,health self-management ability and satisfaction between the two groups were statistically significant(P < 0.05)after intervention for 3 months and 6 months.The life quality,health self-management ability and satisfaction in the experimental group were improved after intervention for 3 months and 6 months compared with the control group.Conclusions:1.The elderly in the community have a relatively high demand for home nursing care,and the most important demand is disease prevention.The main influence factors include the illness status,age,income and expenditure,education,marital status and self-care ability.2.The regional collaborative medical-nursing combined health management platform has reasonable design,convenient and stable operation,and can realize regional information exchanging and resource sharing,improve the service level and management ability of community health institutions.3.The implementation of demand-based regional collaborative medical care combined with home nursing care mode can improve the life quality,health self-management ability and home care satisfaction of community elderly.