中國西部地區老年人養老意願及其影響因素

Living Arrangement Intentions of the Elderly and Its Influencing Factors in Western China

背景：中國是世界上老年人口基數最大的國家，老年人占總人口比率超過17.3％，銀髮浪潮的到來，老年人生活自理能力不同程度下降，中國養老壓力不斷增加，幫助其成功老化是當前急需解決的問題。目的：瞭解西部地區老年人養老意願，為社會養老服務體系的革新提供參考。方法：選取廣西、寧夏地區2,078位老年人，採用自製問卷、Barthel自理能力量表進行調查。結果：1,634人（78.6％）選擇居家養老，187人（9.0％）選擇社區養老，257人（12.4％）選擇機構養老。不同年齡、民族、戶籍、文化程度、家庭人均月收入、家庭收支情況、宗教信仰的老年人養老意願的選擇構成比有顯著性差異（p＜.05）；logistic回歸顯示，年齡、民族、戶籍、信仰、婚姻情況、家庭人均月收入及住院時間是老年人居家養老意願的影響因素（p＜.05）。結論／實務應用：老年人養老意願以居家養老為主，需構建具有醫療功能的居家模式；在社區、機構養老意願攀升同時完善健康服務功能；精准服務契合養老意願，進入養老定制新時代；借力「互聯網＋」智慧養老，構建多元層次化養老服務體系。 Background: China is the country with the largest population of elderly, accounting for more than 17.3% of the total population. The arrival of the so-called “silver wave＂ has generally reduced the abilities of daily life of the elderly and has continued to increase endowment pressures. Assisting the elderly in China to age successfully is an urgent problem. Purpose: To understand the living arrangement intentions of the elderly in Western China and to provide a reference for the reformation of the social endowment service system. Methods: A self-designed questionnaire and Barthel self-care ability scale were conducted on 2,078 elderly people living in Guangxi and Ningxia Provinces in China. Results: A total of 1,634 participants (78.6%) chose home-based care, 187 (9.0%) chose community care, and 257 (12.3%) chose institutional care. Differences in age, ethnic group, household registration, education level, family monthly income, family income and expenditure situation, and religion all significantly affected living arrangement intention (all p ＜ .05). Logistic regression showed that age, ethnicity, household registration, religion, marital status, family monthly income, and length of hospital stay were all primary factors of influence on the home care intention of the elderly people (all p ＜ .05). Conclusions: A significant majority of the elderly in this study expressed an intention to choose home-based care. It will be necessary to build a home-based mode of care that incorporates medical-care functions. In addition, the health service functions of community and institutions should be improved and perfected, as the intention to live in these settings is also growing. Appropriate services should be provided to meet the living arrangement intentions of the elderly in order to start a new era of elderly care customization. Finally, the development and expansion of ＂Internet Plus＂ should be leveraged to build a social endowment service system that meets the comprehensive range of elderly-care needs.