上海市静安区高龄悬空老年人医疗、护理及养老服务利用现状调查
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摘要
目的了解上海市静安区高龄悬空老年人的医疗、护理及养老服务的利用现状,探讨存在的问题及解决方案,以满足高龄悬空老年人的健康保障需求。方法采用目的抽样法,在上海市静安区14个街道中选取老式住宅较为密集的临汾路街道、彭浦新村街道、彭浦镇街道为样本区;再按照1∶1∶1的比例在3个街道内随机抽取居住在老式无电梯楼房3层及以上楼层、年龄80岁及以上的高龄老年人为调查对象。于2017年3月,采用自行设计的调查问卷对高龄悬空老年人进行入户调查。问卷的主要内容包括:高龄悬空老年人的基本情况,过去1个月内对医疗服务、护理服务、养老服务的利用情况。共发放问卷224份,回收有效问卷224份,问卷的有效回收率为100.0%。结果224例高龄悬空老年人中,71.9%(161/224)的老年人过去1个月内使用过医疗服务;使用医疗服务方式为门诊者占72.7%(117/161);使用医疗服务项目为用药、拿药服务者占98.1%(158/161);医疗服务中的困难为下楼困难者占77.6%(125/161)。60.3%(135/224)的老年人过去1个月内使用过护理服务。护理服务由家人和亲属提供者占68.1%(92/135),认为护理服务经济压力大者占40.0%(54/135)。25.4%(57/224)的老年人过去1个月内使用过养老服务。以市场化家政、送餐方式使用养老服务者占39.6%(21/53)。突发情况发生时,准备以自己本人电话方式应对者占52.3%(104/199)。结论上海市静安区高龄悬空老年人对医疗、护理服务的利用率较高,养老服务利用率较低。目前存在部分高龄悬空老年人独居居住安排不合理,护理服务经济压力大、护理服务质量不高,社会化养老服务资源利用不足,紧急情况应对准备不足等问题。建议完善高龄悬空老年人医疗、护理、养老服务提供,建立紧急应对处置的长效机制。
Objective To investigate utilization status of medical,nursing and elderly care service for senior citizens living in high buildings without elevators and to discuss relevant problems and countermeasures in Jingan District of Shanghai.Methods Purposive sampling method was adopted to select Linfen Road Street,Pengpu Xincun Street and Pengpu Town Street which the dense residential buildings without elevators were in from 14 streets of Jingan District in Shanghai.Senior citizens aged 80 years old or older living on the third floor and above in residential buildings without elevators were selectedrandomly in accordance with a ratio of 1∶1∶1: from these three streets.In March 2017,a survey was conducted using self-designed survey questionnaire through in-home visits among these senior citizens.The questionnaire was used to investigate the basic information of respondents and their utilization status of medical,nursing and elderly care service in last month.A total of 224 questionnaires were distributed and all of them were returned.The effective recovery rate was 100.0%.Results Among 224 senior citizens,71.9%(161/224) of them used medical service;60.3%(135/224) of them used nursing service;25.4%(57/224) of them used elderly care service in last month.Among those who used medical service,72.7%(117/161) of them used outpatient service and 98.1%(158/161) of them used medication service.And 77.6%(125/161) of them had difficulty in going downstairs.Among those who used nursing service,40.0%(54/135) of them thought they had great financial pressure on nursing service and 68.1%(92/135) nursing service was provided by family members and relatives.Among those who used elderly care service,39.6%(21/53) of them used the marketized housekeeping and meal delivery.Among 224 senior citizens,emergency contacts were respondents themselves accounting for 52.3%(104/199).Conclusion Senior citizens living in high buildings without elevators in Jingan District of Shanghai have higher utilization rate of medical service and nursing service,while the utilization rate of elderly care service is relatively low.At present,the living arrangements for some senior citizens are unreasonable.Heavy financial pressure and poor quality of nursing service,insufficient utilization rate of socialized elderly care service and inadequate emergency preparedness are still remaining problems.It is recommended that the provision of medical,nursing and elderly care service for senior citizens living in high buildings without elevators should be improved as well as a long-term emergency response mechanism.
Objective To investigate utilization status of medical,nursing and elderly care service for senior citizens living in high buildings without elevators and to discuss relevant problems and countermeasures in Jingan District of Shanghai.Methods Purposive sampling method was adopted to select Linfen Road Street,Pengpu Xincun Street and Pengpu Town Street which the dense residential buildings without elevators were in from 14 streets of Jingan District in Shanghai.Senior citizens aged 80 years old or older living on the third floor and above in residential buildings without elevators were selectedrandomly in accordance with a ratio of 1∶1∶1: from these three streets.In March 2017,a survey was conducted using self-designed survey questionnaire through in-home visits among these senior citizens.The questionnaire was used to investigate the basic information of respondents and their utilization status of medical,nursing and elderly care service in last month.A total of 224 questionnaires were distributed and all of them were returned.The effective recovery rate was 100.0%.Results Among 224 senior citizens,71.9%(161/224) of them used medical service;60.3%(135/224) of them used nursing service;25.4%(57/224) of them used elderly care service in last month.Among those who used medical service,72.7%(117/161) of them used outpatient service and 98.1%(158/161) of them used medication service.And 77.6%(125/161) of them had difficulty in going downstairs.Among those who used nursing service,40.0%(54/135) of them thought they had great financial pressure on nursing service and 68.1%(92/135) nursing service was provided by family members and relatives.Among those who used elderly care service,39.6%(21/53) of them used the marketized housekeeping and meal delivery.Among 224 senior citizens,emergency contacts were respondents themselves accounting for 52.3%(104/199).Conclusion Senior citizens living in high buildings without elevators in Jingan District of Shanghai have higher utilization rate of medical service and nursing service,while the utilization rate of elderly care service is relatively low.At present,the living arrangements for some senior citizens are unreasonable.Heavy financial pressure and poor quality of nursing service,insufficient utilization rate of socialized elderly care service and inadequate emergency preparedness are still remaining problems.It is recommended that the provision of medical,nursing and elderly care service for senior citizens living in high buildings without elevators should be improved as well as a long-term emergency response mechanism.
引文
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[13]钟仁耀.上海市独居老人生活状况分析及其对策[J].社会科学,2004,26(8):66-70.DOI:10.3969/j.issn.0257-5833.2004.08.011.ZHONG R Y.An analysis of the living condition of the elders living alone in shanghai and the policy related[J].Journal of Social Sciences,2004,26(8):66-70.DOI:10.3969/j.issn.0257-5833.2004.08.011.
[2]黄文静.社会学视角下老年人的医疗和照顾需要研究[J].中国全科医学,2017,20(7):842-851.DOI:10.3969/j.issn.1007-9572.2017.07.017.HUANG W J.Medical and caring needs of older people from sociological perspective[J].Chinese General Practice,2017,20(7):842-851.DOI:10.3969/j.issn.1007-9572.2017.07.017.
[3]张莉.对我国高龄老人居住方式影响因素的分析[J].华中科技大学学报(社会科学版),2016,30(1):92-102.DOI:10.3969/j.issn.1671-7023.2016.01.012.ZHANG L.An analysis on the living arrangement determinants among Chinese oldest-old[J].Journal of Huazhong University of Science and Technology(Social Science Edition),2016,30(1):92-102.DOI:10.3969/j.issn.1671-7023.2016.01.012.
[4]海龙.我国高龄老人长期护理需求测度及保障模式选择[J].西北人口,2014,35(2):40-44.DOI:10.3969/j.issn.1007-0672.2014.02.009.HAI L.The analysis of the demand of long-term care for the oldest old and its insurance system constructing in China[J].Northwest Population Journal,2014,35(2):40-44.DOI:10.3969/j.issn.1007-0672.2014.02.009.
[5]彭亮,王裔艳.上海高龄独居老人研究[J].南方人口,2010,25(5):26-33.DOI:10.3969/j.issn.1004-1613.2010.05.004.PENG L,WANG Y Y,Study of the senile living alone in Shanghai[J].South China Population,2010,25(5):26-33.DOI:10.3969/j.issn.1004-1613.2010.05.004.
[6]陈红,任新,荀雪琴,社区高龄独居老人健康自我管理能力状况调查与分析[J].上海医药,2015,36(10):49-51.CHEN H,REN X,XUN X Q.Survey and analysis on the selfmanagement skill of the oldest people who lived alone in the community[J].Shanghai Medical&Pharmaceutical Journal,2015,36(10):49-51.
[7]肖云,温华凤,邓睿.高龄失能老人居住方式及影响因素的实证研究[J].南方人口,2016,31(3):46-56.DOI:10.3969/j.issn.1004-1613.2016.03.005.XIAO Y,WEN H F,DENG R.Analysis of the living mode of the disabled oldest elders and its influencing factors[J].South China Population,2016,31(3):46-56.DOI:10.3969/j.issn.1004-1613.2016.03.005.
[8]张戌凡.城市空巢老年女性生存质量的影响因素与治理策略——基于“五普”和“六普”数据的比较研究[J].南京师大学报(社会科学版),2015,61(4):33-39.DOI:10.3969/j.issn.1001-4608.2015.04.004.ZHANG X F.Factors influencing life quality of empty nest elderly women in urban areas and coping strategies:a comparative study based on the fifth and sixth national censuses data[J].Journal of Nanjing Normal University(Social Science Edition),2015,61(4):33-39.DOI:10.3969/j.issn.1001-4608.2015.04.004.
[9]YANG H,BROWNING C,THOMAS S.Challenges in the provision of community aged care in China[J].Fam Med Community Health,2013,1(2):32-42.DOI:10.15212/FMCH.2013.0206.
[10]上海市老龄科研中心.2015年上海市老年人口和老龄事业监测统计信息[EB/OL].[2018-02-06].http://www.shrca.org.cn/5764.html.
[11]中华人民共和国国家统计局.2016中国统计年鉴[M].北京:中国统计出版社,2016.
[12]薛锦花,赵辉,陈腾澜,等.上海市某社区高龄老人健康状况及医疗护理需求调查[J].中国初级卫生保健,2016,30(9):78-79.DOI:10.3969/j.issn.1001-568X.2016.09.0032.XUE J H,ZHAO H,CHEN T L,et al.Survey on health status and medical care demand of the elderly in a community in Shanghai[J].Chinese Primary Health Care,2016,30(9):78-79.DOI:10.3969/j.issn.1001-568X.2016.09.0032.
[13]钟仁耀.上海市独居老人生活状况分析及其对策[J].社会科学,2004,26(8):66-70.DOI:10.3969/j.issn.0257-5833.2004.08.011.ZHONG R Y.An analysis of the living condition of the elders living alone in shanghai and the policy related[J].Journal of Social Sciences,2004,26(8):66-70.DOI:10.3969/j.issn.0257-5833.2004.08.011.