Analysis of the status quo of the Elderly’s demands of medical and elderly care combination in the underdeveloped regions of Western China and its influencing factors: a case study of Lanzhou

Abstract

Background This study aims to analyse the current demand by senior citizens in Lanzhou, China for a combination of medical and elderly care services and to identify the factors influencing their needs. Methods 7500 participants aged 60 or above living in Lanzhou, China, were recruited, a unified questionnaire concerning elderly people’s demand for a service combining medical and elderly care has been adopted to survey these subjects. The status quo of the demand of the service combining medical and elderly care and its influencing factors were analysed with the single-factor Chi-square test and multi-factor binomial logistic regression method. Results 3772 of 7320 older people have the demand for the service combining medical and elderly care, accounting for 53.15% of survey respondents. Many factors are in play, including gender, marital status, degree of education, occupation before retirement, number of children, monthly income, health self-assessment status, endowment insurance type, medical insurance type, current nursing arrangements, old-age demands, self-care ability and the knowledge of combining medical and elderly care and the willingness to pay for the combination of medical and elderly care have statistical significance (P < 0.05) with the elderly’s needs, different ages, living styles and the prevalence of chronic diseases, have no statistical significance (P > 0.05) with the elderly’s care needs in Lanzhou. The number of children, type of medical insurance and willingness to pay for the combination of medical treatment and nursing care are major influencing factors among the complex factors influencing the elderly’s demand for the proposed service. Conclusions The low knowledge rate and demand rate, the number of children, the type of medical insurance, and the willingness to pay for the medical-nursing combination service for the elderly in Lanzhou have a great impact on the elderly’s demand rate for combining medical and elderly care. Meanwhile, relevant government departments should focus more on the promotion of the endowment model of combining medical and elderly care and provide integrated medical care services by integrating multiple resources, and improving social security.

Exploring the Model of Combining Medical Treatment and Endowment with Science and Education in China

“…by means of technology shares, carry out medical care crowdfunding projects, and promote the "Internet + crowdfunding + pension" model. In terms of financial services for the medical and nursing population, it is necessary to build a "one-stop" integrated medical and nursing service network platform by integrating the original medical insurance information network and the relevant information of the social security card, and implement the "one-stop" real-time settlement of medical and nursing expenses (Wang et al, 2020). Solve the problem of settlement of medical treatment for the elderly in old-age care institutions with integrated medical treatment and endowment.…”

Older Adults’ Demand for Integrated Care and Its Influencing Factors: A Scoping Review

“…Additionally, ageing in China is occurring on a larger scale and at a more rapid pace, creating a heavier dependency burden. The traditional nursing model cannot comprehensively satisfy the complicated care needs of older Chinese adults [ 2 ]. As family support functions continue to weaken and older people’s demand for professional nursing and health services continues to increase, opportunities for innovative older adult care models are emerging [ 3 ].…”

“…In China, ‘ Yiyang Jiehe ’—which means “health and social care combination” or “medical and older adults care combination”—has become synonymous with integrated care for older people [ 2 5 ]. The Chinese government has issued a series of relative policies [ 5 6 ] and designated 90 national pilot cities and more than 300 provincial pilot cities to promote the development of this emerging care model.…”

“…The Chinese government has issued a series of relative policies [ 5 6 ] and designated 90 national pilot cities and more than 300 provincial pilot cities to promote the development of this emerging care model. An increasing number of service delivery modes have been proposed, tested and proven to be effective during this process, e.g., collaboration between medical and older adult care providers or expansion of the service scope of either medical or older adult care providers to cover all services by increasing facilities and personnel [ 2 ].…”

“…The WHO defines integrated care as ‘services that are managed and delivered so that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector, and according to their needs throughout the life course’ [ 19 ]. In contrast, China’s ‘ Yiyang Jiehe ’, which is focused on exploring models of integrated care and their pathways to realization and involves four levels: nursing home, home, community and hospital [ 2 5 ]. The WHO-ICOPE is based mainly on the community level and aims to provide more detailed guidance for the development of integrated care in each country.…”