An Analysis Of The Influencing Factors Of Disability And Institutional Endowment Of The Elderly In Henan Province

ObjectiveTo understand the disability rate and willingness of institutional care of the elderly aged 60 and over in Henan Province,analyze the influencing factors of disability and its importance,identify the high-risk groups of disability,and analyze the care needs of the elderly.In addition,to analyze the influencing factors of willingness of institutional care of the elderly,explore whether the willingness of institutional care of the elderly in the same county or town is similar,provide some reference for relevant departments to formulate pension policies and development strategies for the elderly.MethodsThe data is from the sixth health service survey of Henan Province in 2018.The survey adopts multi-stage stratified cluster random sampling.After data cleaning,8441 cases aged 60 and over were included in the study.Logistic model was used to analyze the influencing factors of disability in the elderly,and decision tree model was used to construct a tree diagram to show the importance and relation of the influencing factors.Multi-level logistic model was used to analyze the influencing factors of the elderly's willingness of institutional care.Two level and three level zero model and variance effect model were established successively,and then the random effect model was established to explore whether the influencing factors had random effects.Draw the normalized residual normal map of town level to verify the model hypothesis.Through the goodness of fit likelihood ratio test,the fitting effect of single level model and multi-level model were compared.Results1.The results of logistic model showed that age,education level,employment status,income level,source of income,chronic disease and dementia had statistical significance(P<0.05).2.The results of the decision tree model show that the root node is disability,and it is divided according to dementia,age,chronic disease,source of income,income level and employment status.The most important factor affecting the disability rate of the elderly is dementia.It can be seen from the terminal node that the disability rate of the elderly with dementia is the highest,49.8%;the next is the elderly with chronic diseases who are 80 years old and over,the disability rate is 31.0%.3.The results of multi-level model show that there is intra group homogeneity in the elderly's willingness of institutional care at the town level(ICC=0.3269).Age,employment status,income level and family care were the influencing factors of willingness of institutional care(P<0.05).Compared with the single level model,the influence of living style(?2=2.153,P=0.142)and medical insurance type(basic medical insurance for urban employees:?2=3.604,P=0.058;no basic medical insurance:?2=0.025,P=0.874)on willingness of institutional care was no longer statistically significant(P>0.05).The random coefficient model found that whether to retire had a random effect(?u1=4.627,P=0.031),that is,whether to retire or not has different effects on the elderly's institutional pension willingness in different towns.Conclusion1.The disability rate of the elderly aged 60 and over in Henan Province is 9.37%,which is lower than that of the urban and rural elderly in China.According to the importance of influencing factors,the influencing factors of disability are dementia,age group,chronic disease,source of income,income level,employment status and education level.The elderly with dementia,old age and chronic disease are the high-risk population of disability.2.At present,the elderly who hope to provide for the elderly in the future still account for a relatively low proportion.There are similarities in the willingness of institutional care of the elderly in the same town.Age,employment status,income level and family care are the influencing factors of willingness of institutional care.