基于Chi-squared automatic interaction detector模型的社区居家医养结合服务利用情况及影响因素分析  

Analysis of the utilization and influencing factors of community home-based Medical-nursing Combined based on Chi-squared automatic interaction detector model

作　　者：董海颖 贾诗宇 万乐平 杨光媚 梁笑笑 何燕 DONG Hai-ying;JIA Shi-yu;WAN Le-ping;YANG Guang-mei;LIANG Xiao-xiao;HE Yan(College of Public Health,Zhengzhou University,Zhengzhou,Henan 450001,China)

机构地区：[1]郑州大学公共卫生学院社会医学与卫生事业管理学系,河南郑州450001

出　　处：《现代预防医学》2023年第20期3742-3748,共7页Modern Preventive Medicine

基　　金：2021年河南省重点研发与推广专项(科技攻关)项目(212102310814);2022年郑州大学教授团队助力企业创新驱动发展专项(JSZLQY2022023)。

摘　　要：目的了解社区居家医养结合服务利用情况及影响因素,为做到精确服务,提升医养结合服务质量提供科学依据。方法2021年9月至11月采用分层整群随机抽样方法,对苏州、广州和青岛8家社区居家医养结合机构的老年人进行问卷调查。采用χ2检验进行单因素分析,采用Chi-squared automatic interaction detector(CHAID)模型分析服务利用的影响因素。结果共回收有效问卷1310份,其中广州218人,苏州334人,青岛758人。医疗服务、健康管理服务、生活照料服务的模型预测正确率分别为82.4%、81.0%、81.7%。CHAID模型分析表明,室内自主参与、地区、主要经济来源、子女数量是医疗服务利用情况的影响因素(P<0.05);地区、自主参与总分、主要经济来源、慢病数量是健康管理服务利用情况的影响因素(P<0.01);自主参与总分、年龄是生活照料服务利用情况的影响因素(P<0.001)。结论社区居家医养结合服务中的医疗服务、健康管理服务、生活照料服务的利用情况仍需要改进,应该为不同特征的老年人提供差异化服务,切实提升医养结合服务质量,满足养老需求。Objective To understand the utilization situation and influencing factors of community home medical care combined service,so as to provide scientific basis for achieving accurate service and improving the quality of medical care combined service.Methods From September to November 2021,stratified cluster random sampling method was adopted to conduct a questionnaire survey among the elderly in 8 community home care institutions in Suzhou,Guangzhou and Qingdao.Chi-square test was used for single factor analysis,and Chi-squared automatic interaction detector(CHAID)model was used to analyze the influencing factors of service utilization.Results A total of 1310 valid questionnaires were collected,including 218 in Guangzhou,334 in Suzhou and 758 in Qingdao.The prediction accuracy of medical service,health management service and life care service were 82.4%,81.0%and 81.7%,respectively.CHAID model analysis showed that indoor voluntary participation,region,main economic source and number of children were influencing factors of medical service utilization(P<0.05).The region,social autonomous participation,main economic source and number of chronic diseases were the factors affecting the utilization of health management services(P<0.01).Social autonomous participation and age were the factors influencing the utilization of life care services(P<0.001).Conclusion The utilization of medical services,health management services and life care services still need to be improved,differentiated services should be provided for the elderly with different characteristics,and the quality of combined medical and nursing services should be effectively improved to meet the needs of the elderly.

关 键 词：社区居家 医养结合 服务利用 影响因素 CHAID 

分 类 号：R197[医药卫生—卫生事业管理]