老年人居家长期照护服务项目体系构建及风险评价
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摘要
目的探讨老年人居家长期照护服务项目体系及其风险水平。方法通过文献回顾、质性访谈拟定老年人居家长期照护服务项目体系草案,采用德尔菲专家咨询法对其进行修订,并对各个项目的风险水平进行初步评价。结果 3轮专家咨询有效回收率分别为94.44%、100%、100%,专家权威系数分别为0.895、0.907、0.885,肯德尔和谐系数为0.404～0.519(P<0.05)。最终确定的服务项目体系包含4项一级指标、13项二级指标、57项三级指标; 4项一级指标下的项目风险等级评分分别为1.47～3.56、1.88～3.35、2.94～3.18、1.94～4.71。结论老年人居家长期照护服务项目体系的内容和风险水平咨询可靠,可为长期照护保险制度的建设提供参考。
Objective To identify the contents and risk of home-based long-term care service for the elderly.Methods The contents of home-based long-term care service for the elderly were drafted after literature review and qualitative interview.Then expert consultation was conducted to revise the draft and evaluate the risk level using the Delphi process.Results The response rates of 3 rounds of expert consultation were 94.44%,100% and 100% respectively.The authority coefficients of expert were 0.895,0.907 and 0.885 respectively;and the Kendall coefficients ranged from 0.404 to 0.519(P<0.05).The contents of home-based long-term care for the elderly consisted of 4 primary indicators,13 secondary indicators and 57 tertiary indicators.The risk scores of items within the 4 primary indicators were 1.47-3.56,1.88-3.35,2.94-3.18 and 1.94-4.71,respectively.Conclusion The contents and risk scoring level of the home-based long-term care service for the elderly are reliable,which can provide reference for development of long-term care insurance system.
Objective To identify the contents and risk of home-based long-term care service for the elderly.Methods The contents of home-based long-term care service for the elderly were drafted after literature review and qualitative interview.Then expert consultation was conducted to revise the draft and evaluate the risk level using the Delphi process.Results The response rates of 3 rounds of expert consultation were 94.44%,100% and 100% respectively.The authority coefficients of expert were 0.895,0.907 and 0.885 respectively;and the Kendall coefficients ranged from 0.404 to 0.519(P<0.05).The contents of home-based long-term care for the elderly consisted of 4 primary indicators,13 secondary indicators and 57 tertiary indicators.The risk scores of items within the 4 primary indicators were 1.47-3.56,1.88-3.35,2.94-3.18 and 1.94-4.71,respectively.Conclusion The contents and risk scoring level of the home-based long-term care service for the elderly are reliable,which can provide reference for development of long-term care insurance system.
引文
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[3]中华人民共和国人力资源社会保障部.人力资源社会保障部办公厅印发《关于开展长期护理保险制度试点的指导意见》[EB/OL].(2016-06-27)[2018-08-15].http://www.gov.cn/xinwen/2016-07/08/content_5089283.htm.
[4]上海市民政局.关于印发长期护理保险服务项目清单和相关服务标准、规范(试行)的通知[EB/OL].(2016-12-30)[2018-08-15].http://www.shmzj.gov.cn/gb/shmzj/node8/node15/node55/node230/node278/u1ai43863.html.
[5]成都市人力资源和社会保障局.关于印发《成都市长期照护保险实施细则(试行)》的通知[EB/OL].(2017-04-10)[2018-08-15].http://admin.cdhrss.gov.cn/uploadfiles/020209/20170426094551.pdf.
[6]中华人民共和国国家卫生和计划生育委员会.全国护理事业发展规划(2016-2020年)[EB/OL].(2016-11-18)[2018-08-15].http://www.nhfpc.gov.cn/yzygj/s3593/201611/92b2e8f8cc644a899e9d0fd572aefef3.shtml.
[7]Japan Ministry of Health,Labour and Welfare.Annual Health,Labour and Welfare Report 2017[EB/OL].[2018-10-15].https://www.mhlw.go.jp/english/wp/wp-hw11/dl/10e.pdf.
[8]Mot E,Aouragh A,De Groot M,et al.The Dutch system of long-term care[R].European Network of Economic Policy Research Institutes,2010.
[9]Rhee J C,Done N,Anderson G F.Considering long-term care insurance for middle-income countries:comparing South Korea with Japan and Germany[J].Health Policy,2015,119(10):1319-1329.
[10]罗萌.中国台湾地区长期照护制度及其启示[J].老龄科学研究,2017,5(3):52-60.
[11]程书肖.教育评价方法技术[M].北京:北京师范大学出版社,2004:47-59.
[12]李沛良.社会研究的统计应用[M].北京:社会科学文献出版社,2002:113-114.
[13]曾光.现代流行病学研究方法与应用[M].北京:北京医科大学中国协和医科大学联合出版社,1994:250-270.
[14]井坤娟,王彦,杜小静,等.基于扎根理论老年人居家养老服务需求理论框架构建研究[J].中国实用护理杂志,2015,31(23):1774-1777.
[15]张卫红,袁慧琳,靳岩鹏,等.社区老年人居家养老服务需求及影响因素[J].中国老年学杂志,2016,12(36):3032-3033.
[16]孔令磷,赵梦遐,鲍翠玉,等.社区老年人居家护理服务需求及影响因素分析[J].护理学杂志,2016,31(7):15-17.
[17]上海市卫生和计划生育委员会.关于印发《上海市护理站管理办法》的通知[EB/OL].(2016-09-07)[2018-08-15].http://www.wsjsw.gov.cn/wsj/n429/n432/n2354/n1537/u1ai138480.html.
[18]广东省卫生和计划生育委员会.广东省中医药局关于护士区域注册的管理办法[EB/OL].(2018-03-19)[2018-08-15].http://www.dgwsj.gov.cn/dgwsjd/yljg/201805/759a188fed3f4c489a94ef20624c63eb.shtml.
[19]宋健敏.日本社会保障制度[M].上海:上海人民出版社,2012:255.
[20]支晨,皮红英,章洁.国外长期护理保险的现状及对我国老年护理服务保障的启示[J].护理学杂志,2015,30(11):95-98.(本文编辑王菊香)