老年人长期护理需求的差异性研究

发布时间：2018-07-14 09:40

【摘要】：我国老年人失能状况严重,老年人口健康状况不容乐观,老年人长期护理服务需求持续上升。因此,了解我国老年人长期护理需求的差异性,对于在全国范围内合理配置长期护理服务资源及提供长期护理服务以满足老年人长期护理需求,保障老年人晚年生活质量,构建健康老龄化社会具有重要意义。本论文从地区和时间两个角度对老年人长期护理需求的差异性进行研究。在地区差异方面,通过选取2010年第六次人口普查数据及各地区人口统计数据,采用SPSS聚类分析方法和统计分析方法对各地区老年人失能率和失能规模进行了比较分析。结果显示:(1)需要护理的老年人比例地区差异大。根据老年人失能率、老年人口抚养比、人口老龄化程度、地区GDP所占比重和人均GDP五个指标得出六类聚类地区,这六类地区老年人口特征各不同。除了经济发展水平不同,地区间医疗卫生资源分配不平衡、人口政策执行力度不同、社会环境变化等诸多因素都是差异形成的原因。(2)需要护理的老年人规模地区差异大。根据各地区老年人失能率计算各地区失能老年人数量,得出我国失能老人基数大,且分布地区复杂。在时间差异方面,选取北京大学老龄健康与家庭研究中心2008年和2011年全国老年人口健康状况调查项目(CLHLS)数据,通过统计分析方法将2008年与2011年老年人失能状况分别从整体功能、性别、年龄、等级等方面进行比较分析和评价。评价显现:(1)与2008年相比,2011年老年人整体失能率上升,各项功能活动失能率都有所上升;2011年分性别、年龄、城乡老年人各项功能活动障碍率相较于2008年均有所增加,老年人整体健康状况恶化。(2)与2008年相比,2011年老年人各项生活自理能力丧失的比例增大,其中洗澡这一功能完全丧失的老年人上升幅度最大;分项数生活自理能力丧失的比例上升;分年龄老年人失能率上升,高龄老年人上升幅度大;分性别老年人失能率上升,女性高龄老年人失能率增加幅度显著;分城乡老年人失能率上升,农村老年人失能率高于城镇老年人。(3)轻中度失能老年人在老年人总体中所占比重最高,并随着时间变化上下波动。而重度失能老年人所占比重处于上升态势,这意味着重度失能老年人规模在扩大,而这部分老年人对老年人长期护理的需求最迫切。最后,就应对老年人长期护理需求的差异性提出几点对策建议:(1)推行长期护理资源规划。在失能率高的经济发达的北京、天津、上海等地区发展机构养老服务,在失能规模大的四川、河南、山东等中西部地区发展“医养融合”机构养老,在少数民族偏远地区推行满足其实际需求的特色护理模式以及依托社区和社会的力量缩小城乡护理资源差异等。(2)探索长期护理发展策略。时间上,中高年龄段、女性失能老年人口在全部失能老年人口中占比较大且逐年增加。为应对失能老年人日益高龄化、女性化和重度失能化,推行“以老养老”护理模式、改善老年居住环境、夯实家庭养老护理功能等。(3)打破长期护理资金困境。无论地区或时间的差异,面临越来越沉重的养老负担,长期护理资金困境亟待解决。长期护理保险制度有待进一步探索和建立。
[Abstract]:The disability status of the elderly in our country is serious, the health status of the elderly population is not optimistic, and the demand for long-term care service for the elderly continues to rise. Therefore, to understand the difference of the long-term care demand for the elderly in China, the rational allocation of long-term nursing service resources and long-term nursing service in the whole country to meet the long-term care needs of the elderly people. It is of great significance to ensure the old people's quality of life in their later years and to build a healthy aging society. This paper studies the differences of the long-term care needs of the elderly from two aspects of region and time. In terms of regional differences, the sixth census data of 2010 and the population statistics of various regions are selected, and the SPSS cluster analysis is adopted. The results showed that (1) the proportion of elderly people in need of nursing was very different. According to the disability rate of the elderly, the rearing ratio of the aged, the aging degree of the population, the proportion of GDP in the region and the five indexes of per capita GDP, the six clustering areas were obtained, which six The characteristics of the elderly population are different. In addition to the different economic development level, the distribution of medical and health resources is not balanced, the implementation of the population policy is different, the social environment changes are the reasons for the difference. (2) the old people in need of nursing are different. The number of disabled elderly people in the area has been found that the number of disabled elderly in China is large and the distribution area is complex. In terms of time difference, the data of the national health and health status survey project (CLHLS) of the National Center for aging health and family research of Peking University in 2008 and 2011 are selected, and the disability status of the elderly in 2008 and 2011 is respectively analyzed by statistical analysis. From the overall function, gender, age, grade and other aspects, the evaluation showed that: (1) compared with 2008, the overall disability rate of the elderly increased in 2011 and the disability rate of various functional activities increased. In 2011, the gender, age, and the rate of functional activity barriers of the elderly people in urban and rural areas were all increased compared to 2008, and the elderly were whole. Body health deteriorated. (2) compared with 2008, the proportion of elderly people who lost their self-care ability increased in 2011, of which the elderly people who had completely lost the function of bathing were the biggest; the proportion of the separate number of life self-care ability was increased; the age of age and seniors increased, the age of old and old people increased greatly; gender seniors were older. The inability rate of the elderly increased significantly, the rate of disability increased significantly in the elderly and the elderly, and the disability rate of the elderly in urban and rural areas was higher than that of the old people in the town. (3) the proportion of the elderly in the elderly was the highest in the elderly, and with the change of time, the proportion of the elderly was in the upper part. This means that the scale of elderly people with severe disability is expanding, and this part of the elderly has the most urgent need for long-term care for the elderly. Finally, some suggestions are put forward to deal with the differences of the long-term care needs of the elderly: (1) the implementation of long-term nursing resource planning. In the economically developed Beijing, Tianjin, Shanghai and other areas with high disability rates To develop the old-age service for the elderly in Sichuan, Henan, Shandong and other central and western regions in the middle and western regions of China, to develop the pension system in the central and western regions, such as the central and western regions of Shandong, and to carry out the characteristic nursing mode to meet its actual needs in the remote minority areas and to reduce the differences of urban and rural nursing resources depending on the community and society. (2) explore the long-term nursing development strategy. In time, middle and high age, female disabled elderly population is larger and increasing year by year in all the disabled elderly population. In order to cope with the aging of the elderly, feminization and severe disability, the implementation of "old care" nursing mode, improve the elderly living environment, rammed family nursing function, and so on. (3) break the long-term nursing capital. No matter the difference in region or time, the burden of pension is getting heavier and heavier, and the long-term care fund dilemma is urgently to be solved. The long-term care insurance system needs to be further explored and established.
【学位授予单位】：浙江财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：D669.6

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