基于Andersen行为模型的机构内老年人医养结合模式选择及其影响因素研究  

Combination of Medical and Nursing Care Mode of the Elderly in Institutions and its Influencing Factors based on Anderson Behavior Model

作　　者：司明舒 邵梅英[5] 吴胤歆[1,2,3,4] 刘慕淳 苏源 崔乃雪 Si Mingshu;Shao Meiying;Wu Yinxin(School of Public health,Fujian Medical University(350122),Fuzhou)

机构地区：[1]福建医科大学公共卫生学院,350108 [2]福建省医疗改革与发展研究中心 [3]健康福建研究中心,福建福州 [4]福建省康复养老与产业促进协同创新中心 [5]山东大学齐鲁医院 [6]宁夏医科大学公共卫生与管理学院 [7]山东大学护理学院

出　　处：《中国卫生统计》2021年第1期33-38,共6页Chinese Journal of Health Statistics

基　　金：教育部人文社会科学研究项目(19YJC630144);福建省中青年教师教育科研项目(人力资源管理专项)(JZ180330);福建医科大学高层次人才启动项目(XRCZX2019023)。

摘　　要：目的了解老年人对医养结合机构服务模式选择意愿及其影响因素,为构建全方位、多层级、不同类型"医养结合"机构服务体系提供科学参考。方法基于Andersen行为模型,通过焦点访谈和问卷调查,采用多阶段分层抽样方法于2017年6月-2018年8月对青岛市7个区43家医养结合机构2040位入住老年人进行问卷调查,构建多分类logistic回归模型,分析机构老年人医养结合模式选择的影响因素。结果机构老年人当中选择养中有医模式最多(42.32%),医养并重的次之(37.55%),医中有养的最少(20.14%)。与医养并重模式相比,中低教育程度、健康状况好、半自理、无任何疾病、睡眠时间较短的老年人更愿意选择养中有医机构模式(P<0.05);教育程度低、与子女在同一市居住、无任何疾病、睡眠时间较短的老年人更愿意选择医中有养机构模式(P<0.05)。从Andersen模型各维度来看对医养结合机构模式选择影响最大的是促成性因素,其次分别是需求性因素、倾向性因素和健康行为因素。结论青岛市机构老年人医养结合模式选择以养中有医机构模式最多,机构老年人医养结合模式选择受社会人口学特征、居住安排、健康状况和日常生活状况等因素的影响,其中促成性因素影响最大。Objective To explore the elderly′s willingness to choose the service mode of medical and nursing care combination institutions and its influencing factors,so as to provide a scientific reference for building a comprehensive,multi-level and different types of“integrated medical and nursing care”institutional service system.Methods Based on the Andersen behavior model,through focus interview and questionnaire survey,a questionnaire survey was conducted among 2040 elderly people in 43 medical and nursing institutions in 7 districts of Qingdao from June 2017 to August 2018 by using multi-stage stratified sampling method,and a multi classification logistic regression model was constructed to analyze the choice and its influencing factors of the mode of integrated medical and nursing care of the elderly.Results Among the elderly in institutions,42.32%of them choose the medical institution within the pension institution model,37.55%of them pay attention to medical pension institution,and 20.14%of them choose the pension institution within the medical institution model.Compared with the medical pension institution,the elderly with middle and low education level,good health,half self-care,no disease and short sleep time were more willing to choose the mode of the medical institution within the pension institution model(P<0.05);the elderly with low education,living in the same city with their children,no disease and short sleep time were more willing to choose the mode of the pension institution within the medical institution(P<0.05).From the perspective of Andersen model,the most influential factors on the choice of medical and nursing institutions are the promotion factors,followed by the demand factors,propensity factors and health behavior factors.Conclusion The mode of the medical institution within the pension institutionis the most common one oftheselections of integrated medical and nursing care for the elderly in institutions in Qingdao.The selection of the mode of integrated medical and nursing care for the

关 键 词：医养结合 模式选择 影响因素 Andersen行为模型 

分 类 号：R195[医药卫生—卫生统计学]