Other TitlesDifferences in Current Operation Status between the Long-term Care Facilities with Various Durations in Beijing
Health services for the aged
Healthcare disparities
Long-term care facilities
Issue Date2017
Citation中国全科医学. 2017, 20(17), 2099-2105.
Abstract目的 调查北京市不同成立年限养老机构运行现状的差异,为探索适合我国国情的养老机构运营模式提供参考,为相关政策的制定提供理论依据.方法 采用便利抽样法,于2014年8月对北京市养老机构进行调查.采用自行设计的问卷进行调查,内容包括机构基本特征、收住情况、员工情况、社会福利功能及医疗保障情况.采用单因素分析及多因素Logistic回归分析不同成立年限养老机构的运行现状.结果 共发放问卷374份,回收有效问卷361份,有效回收率为96.5%.361所养老机构中成立年限≤5年57所(15.8%),6~15年161所(44.6%),16~20年31所(8.6%),≥21年112所(31.0%).不同成立年限养老机构所在区县、机构性质、土地权属、房产权属、总床位数、床位投保率、护理型床位数所占比例、床均占地面积、建筑面积、床均固定资产比较,差异均有统计学意义(P<0.05).不同成立年限养老机构床位使用率、收住社会人群所占比例、收住60~69岁人群所占比例、收住70~79岁人群所占比例、收住80~89岁人群所占比例、收住≥90岁人群所占比例、收住自理人群所占比例、收住不能自理人群所占比例、收住本乡镇人群所占比例、收住本区县人群所占比例、收住外区县人群所占比例、收住外省人群所占比例比较,差异均有统计学意义(P<0.05).不同成立年限养老机构的员工总数/床位数、护理员总数/床位数、有无医生、有无护士比较,差异均有统计学意义(P<0.05).不同成立年限养老机构是否属于低保不能自理人群定点接收机构、收住"三无五保"人群所占比例、有无经卫生部门批准的医疗保障、是否与就近医疗机构签订医疗保障协议、医疗保障是否纳入医保定点比较,差异均有统计学意义(P<0.05).多因素Logistic回归分析结果显示,不同成立年限养老机构的床位使用率、收住情况、机构性质、医疗保障、人力配置方面比较,差异均有统计学意义(P<0.05).结论 不同成立年限养老机构在床位使用率、收住情况、机构性质、医疗保障、人力配置方面存在差异,应结合不同成立年限养老机构之间的差异,梳理我国机构养老服务的发展趋势,探索适合我国国情的养老机构服务及管理模式.
Objective To investigate the differences in current operation status between the long-term care facilities with various durations in Beijing,so as to provide references for developing the operation patterns of long-term care facilities suitable for the situation of China,and to provide a theoretical basis for the enacting and formulating of the relative policies.Methods This questionnaire survey was conducted in the long-term care facilities in Beijing selected by convenience sampling in August 2014.The self-made questionnaire used in the study involved the baseline characteristics of the facilities,status of admission,status of employees,social welfare function,provided medical services and so on.Single factor analysis and multiple Logistic regression were used to investigate the current operation status of the long-term care facilities with various durations.Results A total of 374 long-term care facilities received the questionnaire survey.Of them,96.5%(361/374) returning responsive questionnaires were selected as the final subjects.Classified by the duration,there were 4 categories in the 361 long-term care facilities:15.8%(57/361) had a duration of ≤5 years,44.6%(161/361) had a duration of 6-15 years,8.6%(31/361) had a duration of 16-20 years,and 31.0%(112/361) had a duration of ≥21 years.The 4 categories of long-term care facilities differed significantly in the location,ownership of the facilities,land ownership,housing property ownership,number of beds,insured bed rate,proportion of nursing beds,per bed covered area in average,construction area of the facilities,and per bed fixed assets(P<0.05).The 4 categories of long-term care facilities were found to have obvious differences in bed occupancy rate,proportion of public residents,proportions of admitted people in age groups of 60 to 69 years,70 to 79 years,80 to 89 years,and 90 years or over,proportion of admitted self-care people,proportion of admitted people without self-care ability,proportions of admitted people from the local towns and districts(counties),from other districts(counties) and provinces(P<0.05).The 4 categories of long-term care facilities had substantial differences in the overall number of staff/number of beds ratio,overall number of nursing assistants/number of beds ratio,status of doctor employment,and status of nurse employment(P<0.05).The 4 categories of long-term care facilities demonstrated differences in terms of whether be the appointed facilities receiving the people without self-care ability living on subsistence allowances,proportions of admitted urban people of "three noes"(no ability to work,no source of income and no statutory supporters) and admitted rural people supported by the five guarantees(food,clothing,medical care,housing and burial expenses were provided by the government),whether offering medical services approved by the health administrative departments,whether affording medical services with the support of nearby medical institutions based on the cooperation agreement,and whether the provided medical services were covered by medical insurance(P<0.05).The multiple Logistic regression analysis found that,in the 4 categories of long-term care facilities,there were distinct differences in bed occupancy rate,status of admission,ownership of the facilities,provided medical services and manpower allocation(P<0.05).Conclusion Long-term care facilities with various durations have significant differences in bed occupancy rate,status of admission,ownership of the facilities,provided medical services and manpower allocation.Therefore,it is suggested that predicting the development trend and developing the service and management mode of long-term care facilities suitable for China′s national conditions should be based on the current operation status of them.
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