Research On The Demand Of The Integration Of Medical Care And Health Services For Elderly In Jinan

【Objective】To understand the attitudes and views of the elderly in Jinan community.To investigate the status and demand of integration of medical care for community elderly in jinan.To analyze the level of self-health management.From the perspective of active aging,welfare pluralism and self-health management,put forward suggestions to improve the elderly community home-based care.【Methods】Methods of cross-sectional study and phenomenon research were used.15 elderly people were selected by maximum variation sampling method for indepth interview,and the qualitative data were analyzed by Colaizzi’s phenomenological analysis method.Based on expert interviews,the “demand for elderly community home-based pension questionnaire”was designed.A questionnaire survey was conducted with general situation questionnaire,demand for elderly community home-based pension questionnaire,adult health self-management ability assessment tool,Daily living ability scale among310 elderly people in five communities in Jinan,Shandong province,300 questionnaires were effectively recovered.SPSS21.0 was used to conduct statistical analysis.【Results】1.The result of qualitative interviews showed the elderly have a positive attitude towards pension,the way of providing for the aged in the community is increasingly accepted,emphasizing the importance of improving the quality of pension agency;Most of the elderly are not familiar with the mode of integration of medical care,and think that the cost is high and bear great economic pressure;Some of the elderly hope to improve medical care and enhance the ability of medical care to provide door-todoor services;Their demand for pension mainly focuses on life care,health management,spiritual and cultural life,health guidance of traditional Chinese medicine,and hope get certain subsidies and support.2.The highest score in the medical rescue of the elderly was 3.99±0.97,and the score in health management,social security services,health guidance of traditional Chinese medicine,life care,health education,rehabilitation guidance of chronic diseases,home nursing,and psychological services was 3.88±0.74,3.77±0.69,3.76±0.94,3.73±0.80,3.70±0.89,3.56±0.91,3.46±0.69,3.45±0.64.3.The results of univariate analysis showed elderly in community with different gender,marital status,education level,occupation,economic source,family per capita income,medical payment method,number of children,living condition,understanding degree of endowment policy,endowment expenses had significant differences in community home care demands(P<0.05).The results of multiple factors regression analysis showed that education level,endowment expenses,medical payment method(provincial medical insurance),family per capita income,the understanding of pension policy were significantly positive influence on community home care needs(P<0.05),the medical payment method(at their own expense)was significantly negative influence on community home care demands(P<0.05).4.There was a positive correlation between the community home care and the total score of self-health management,healthy self-management behavior,healthy self-management environment,healthy self-management cognition(r=0.343,P <0.01;r=0.184,P <0.01;r=0.358,P< 0.01;r=0.281,P < 0.01).It suggested that the higher the level of self-health management,the higher demand of the community home care.【Conclusion】1.The elderly have a positive attitude towards pension,the concept of providing for the aged changed;Most of the elderly know little about the integrated medical care and pension model,also need to be mature and perfect;The elderly eager for professional medical care services;Their demands mainly focus on life care,spiritual and cultural life,health guidance of traditional Chinese medicine,health management;Some elderly people have great economic pressure and hope that the national pension policy can continue to improve.2.The elderly have a strong demand for community home care servicesn.The development of integration of medical care can satisfy the demands of the elderly in the community.3.The results showed elderly in community with different gender,marital status,education level,occupation,economic source,family per capita income,medical payment method,number of children,living condition,understanding degree of endowment policy,endowment expense had significant differences in community home care demands.Among the results,the education level,pension policy understanding,pension expenses,medical payment method,family per capita income were the influencing factor of community home care demands.4.There was a positive correlation between the demand of the community home care services and self-health management.