基于养老服务需求的养老资源划界方法的开发与应用研究  

Development and allocation of regional elderly care resources based on the service needs

作　　者：赵珊珊 顾吉 金敏洁 陆萍 高波 戈园园 严海风 Zhao Shanshan;Gu Ji;Jin Minjie;Lu Ping;Gao Bo;Ge Yuanyuan;Yan Haifeng(Malu Township Community Health Service Center of Jiading District,Shanghai 201801,China)

机构地区：[1]上海市嘉定区马陆镇社区卫生服务中心,201801

出　　处：《中华全科医师杂志》2019年第2期151-155,共5页Chinese Journal of General Practitioners

基　　金：上海市卫生和计划生育委员会科研项目(201640333);上海市中西医结合学会2016年社区医学与健康管理研究项目(2016SH07);上海市嘉定区卫生和计划生育委员会2014年科研项目(2014-KY-12).

摘　　要：目的 构建区域内养老服务资源的供给划界标准,并应用该划界标准评价马陆镇辖区养老资源分配的精准性,为区域养老资源合理配置给需方提供依据和改进建议。 方法 于2016年2月20日至5月4日,通过面对面问卷调查对上海市嘉定区马陆镇辖区60岁以上居民4 312人进行养老服务需求测量;于2016年11月,通过电话调查方式对上海市嘉定区马陆镇辖区养老服务资源总量调查。养老服务需求的划界综合考虑供方资源分级,以及需方需求评分结果。基于划界标准应匹配给老年人的养老场所与其当前养老场所的比较,采用Kappa一致性检验。 结果 划界结果显示,养老服务需求评分≥44.5分的老年人,此次调查中有8人(0.2%)满足,应匹配护理院养老;养老服务需求评分在24.1~44.4分的老年人,有218人(5.1%)满足,应匹配福利院养老;养老服务需求评分在23.2~24.0分的老年人,有60人(1.4%)满足,应匹配养老院养老;养老服务需求评分在22.1~23.1分的老年人,有72人(1.7%)满足,应匹配社区养老;养老服务需求评分≤22.0分的老年人,有3 954人(91.6%)满足,应匹配居家养老。与老年人目前的养老场所比较结果显示,划界结果划定的应匹配养老场所与其一致性较差(Kappa=0.092,P<0.01)。 结论 本研究为马陆镇各级养老服务资源的服务对象设置了划界标准,为区域养老服务资源的有序、合理、公平分配提供了依据;区域老年人目前养老服务资源的匹配尚未基于老年人的养老服务需求实现精准匹配,这有待引入本标准进行改善。Objective To develop and allocate regional elderly care resources based on local service needs. Methods From February 2016 to May 2016, a face-to-face questionnaire survey was conducted to measure the elderly care service needs among residents over 60 years of age in Malu Township of Shanghai Jiading District. A telephone survey on the old-age care resources in Malu Township was carried out in November 2016. The demarcation of the aged care service needs was considered according to the resource classification from supplier side and the needs scores from the demander side. Kappa consistency test was used to compare the current care setting and the care setting matched to the real needs on the basis of the demarcation criteria. Results The results of the demarcation showed that 8 old-aged with score ≥ 44.5 in the survey (0.2%) should have the skilled nursing facility-based care;218 with the score of 24.1 to 44.4 (5.1%) should have the welfare institution-based care;60 with score of 23.2 to 24.0 (1.4%) should have elderly home-based care;72 with scores of 22.1 to 23.1 (1.7%) should have the community-based care;3 954 with score ≤ 22.0 (91.6%) should have home-based care. The consistency between the status of current care setting and the care setting matched to the real needs based on the demarcation criteria was poor (Kappa=0.092, P<0.01). Conclusions This study sets a grading criterion for the service objects of the various aged care services in Malu Township, and provides a basis for the orderly, rational and fair distribution of the regional old-age care service resources. However, the current resource allocation in the region is not accurately matched to the real needs, the problem should be solved with the application of the demarcation criterion.

关 键 词：养老服务 需求 资源 划界标准 

分 类 号：D669.6[政治法律—政治学] F719[政治法律—中外政治制度]