老年人社区康复服务需求及其影响因素

doi:10.3969/j.issn.1006-9771.2021.03.015

Abstract

Abstract: Objective

To investigate the current status of community rehabilitation services for the older adults and the related factors based on the framework of Anderson Health Model and World Health Organization Community-based Rehabilitation Guideline.

Methods

Data from 2016 China Longitudinal Aging Social Survey were analyzed with multiple response to explore the needs of community rehabilitation services, analyzed with Logistic regression to explore the related factors.

Results

The older adults needed somehow community rehabilitation services (11.07%). However, the ratio of actual utilization of rehabilitation services (0.94%) and the meeting of needs (6.75%) were very low. The demand of community rehabilitation services related with education among the propensity factors (OR = 1.299); income (OR = 1.245), pensions (OR = 1.337), financial support from children (OR = 1.236), community's health support services (OR > 1.547) and community participation (OR = 1.640) among the enabling factors; disability (OR = 2.336) and suffering some chronic diseases (diabetes, cerebrovascular diseases, cervical and lumbar diseases, and Alzheimer's disease, etc.) among the demand factors.

Conclusion

There are structural differences between the demand and supply of community rehabilitation services for the older adults. Education, economic conditions, community's health support services, community participation and health status are the factors related with the needs of community rehabilitation services, in the framework of Community-based Rehabilitation Guideline.

Key words: aged, community rehabilitation services, needs, determinants, Anderson Health Model, Community-based Rehabilitation Guideline

CLC Number:

R592

Jia-ming SHI,Xiao-ting LIU. Demands and Determinants of Community Rehabilitation Services for Older Adults[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(3): 334-340.

Figures/Tables 3

References 31

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变量类别		变量定义		%	在康复需求中的占比(%)	χ²值	P值
因变量		康复训练需求	否	89.74
			是	10.26
		康复辅具租用需求	否	90.96
			是	9.04
		总的康复服务需求	否	88.93
			是	11.07
倾向因素	教育	教育程度	小学及以下	67.23	10.45	7.637	< 0.001
			初中及以上	32.77	12.44
使能因素	谋生	老年再就业	否	87.26	11.10	0.071	0.790
			是	12.74	10.85
		个体年收入	0~20 000元	51.19	9.53	24.676	< 0.001
			20 000元以上	48.81	12.67
		养老金	否	27.40	8.91	17.654	< 0.001
			是	72.60	11.88
	社会	婚姻状况	无配偶	28.72	11.31	0.244	0.618
			有配偶	71.28	10.97
		子女经济支持	否	64.12	10.08	17.355	< 0.001
			是	35.88	12.82
		社区上门护理服务	否	98.56	10.32	386.092	< 0.001
			是	1.44	62.24
		社区上门看病服务	否	97.48	10.14	332.802	< 0.001
			是	2.52	46.80
		社区免费体检服务	否	75.41	9.03	128.093	< 0.001
			是	24.59	17.31
		社区健康讲座	否	96.10	10.34	130.763	< 0.001
			是	3.90	28.94
		体育运动	否	83.59	10.84	2.294	0.130
			是	16.41	12.15
	赋能	参与政治生活	否	49.54	10.12	8.853	0.003
			是	50.46	12.00
		参与社区活动	否	83.52	9.50	126.176	< 0.001
			是	16.48	19.03
需求因素	健康	失能程度	完全自理	84.22	10.13	106.215	< 0.001
			相对失能	10.72	11.85
			完全失能	5.05	24.95
		慢性病	否	43.77	10.69	4.082	0.040
			是	56.23	11.35

项目	需求	服务获得率	有需求的服务获得率
康复训练需求	10.26	0.79	5.80
康复辅具租用需求	9.04	0.72	5.13
总的康复服务需求	11.07	0.94	6.75

变量类别		变量(参照变量)	B(SE)	OR	95% CI	P值
倾向因素	教育	教育程度(小学及以下)	0.261(0.108)	1.299	1.102~1.469	0.040
使能因素	谋生	老年再就业(否)	-0.219(0.173)	0.803	0.600~1.178	0.314
		个体年收入(0~20 000元)	0.219(0.07)	1.245	1.082~1.428	0.002
		养老金(否)	0.290(0.082)	1.337	1.138~1.570	< 0.001
	社会	婚姻状况(无配偶)	0.007(0.080)	1.007	0.861~1.178	0.932
		子女经济支持(否)	0.212(0.069)	1.236	1.078~1.416	0.002
		社区上门护理服务(否)	1.566(0.234)	4.786	3.024~7.573	< 0.001
		社区上门看病服务(否)	0.931(0.183)	2.537	1.771~3.633	< 0.001
		社区免费体检(否)	0.490(0.076)	1.632	1.405~1.896	< 0.001
		社区健康讲座(否)	0.437(0.142)	1.547	1.172~2.043	0.002
		体育运动(否)	-0.045(0.139)	0.956	0.761~1.307	0.997
	赋能	参与政治生活(否)	-0.019(0.105)	0.981	0.808~1.219	0.942
		参与社区活动(否)	0.495(0.129)	1.640	1.124~2.135	< 0.001
需求因素	健康	失能(完全自理)
		相对失能	0.109(0.109)	1.115	0.901~1.381	0.317
		完全失能	0.849(0.130)	2.336	1.811~3.014	< 0.001
		患慢性疾病(否)	0.205(0.100)	1.209	1.004~1.652	0.040
		患糖尿病(否)	0.416(0.113)	1.516	1.215~1.892	< 0.001
		患脑血管疾病(否)	0.487(0.127)	1.628	1.269~2.088	< 0.001
		患颈腰椎疾病(否)	0.233(0.114)	1.263	1.009~1.580	0.041
		患阿尔茨海默病(否)	0.613(0.298)	1.846	1.030~3.309	0.040
		常量	-2.445(0.181)	0.087		< 0.001

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Demands and Determinants of Community Rehabilitation Services for Older Adults

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