Establishment And Detection Of Disability Evaluation Of Index System In Long Term Care Insurance

Objective:Based on the disability characteristics of elderly people in eastern China,domestic and foreign research on index system of long-term care disability evaluation and ICF language and framework,this study establishes a scientific,feasible and compound index system of long-term care disability evaluation.For a scientific data basis and decision support of the index system,we find the problems of index system and analyze the influencing factors of disability in different dimensions in real application.Method:(1)Through literature research,we establish concepts and connotations of long-term care insurance and disability,review policies related to long-term care insurance in developed countries and pilot cities in China,summarize the domestic and foreign research results,formulate the theoretical system of disability evaluation for long-term care insurance.(2)Based on the data of China Health and Retirement Longitudinal Study in 2015,we analyze the indicators of ADL and IADL and the status of disability of the elderly in China,and summarize the characteristics of disability of the elderly with different sociological demographic characteristics.(3)The evaluation index pool of long-term care insurance disabled elderly was developed by means of expert interviews.By Delphy method,30 experts from Guangzhou universities,hospitals,pension institutions and medical insurance were consulted.Finally,the index system of long-term care disability evaluation was established through two rounds of expert consultations.(4)Utilizing the index system of long-term care disability evaluation,We assessed the people living in three pension institutions in Haizhu district and Panyu district of Guangzhou to test index reliability and validity and analyze the interaction of each dimension of ability by convenience sampling.Results:(1)ADL and IADL indicators were used to evaluate long-term care needs at home and abroad by literature research.Standard,comprehensive and unified evaluation system is adopted to evaluate the functional status of the long-term care demanders and mediating variables were selected to transform body status and care service demand in developed countries.(2)According to the data analysis of CHARLS in 2015,the high rate of ADL disability indicators of the Chinese elderly was toilet,bath,bed,while the high frequency of IADL disability indicators was making a phone call,doing housework and managing finance.The high frequency of ADL disability indicators of eastern elderly in China was toilet,bath,while its’ IADL disability indicators was doing housework and making a phone call.(3)The index system of long-term care disability evaluation included three primary indicators of body functions and activities,mental activities and social participation,and six secondary indicators and twenty-eight third indicators.(4)Three primary indicators of long-term care disability evaluation influenced each other and its’ influencing factors were different.Conclusions:(1)The index system of long-term care disability evaluation included three primary indicators of body functions and activities,mental activities and social participation.The composite evaluation index system can assess the functional status of the elderly in multiple dimensions.China just got started on the long-term care insurance,so the application of a composite evaluation system should focus on daily activities.(2)The functions of different dimensions of the elderly are independent and interactive because of the affecting factors,so attention should be paid to the effect of influencing factors in the application process.