A study on the health service demands and influence factors among elderly people based on a community survey in Western China†

Healthcare needs and satisfaction rates of elderly people residing at home_

Aspects and variables	Demand, N	Demand rate (%)	Demand rank	Satisfied, N	Satisfied rate, N	Satisfied rank
Physiological and psychological health needs
A1. Creating health record	333	90.98	3	246	73.87	2
A2. Regular medical examination	352	96.17	1	258	73.3	3
A3. Health condition monitoring	346	94.54	2	270	78.03	1
A4. Psychological care	246	67.21	5	153	62.2	5
A5. Family support	263	71.86	4	192	73	4
A6. Indwelling catheter care	47	12.84	9	26	55.32	9
A7. Wound care	46	12.57	10	28	60.87	6
A8. Excretion nursing	54	14.75	8	32	59.26	7
A9. Auxiliary phlegm expulsion	66	18.03	7	39	59.09	8
A10. Hospice and palliative care	74	20.22	6	a	a	A
Daily life care
B1. Medical companionship service	202	55.19	1	108	53.47	2
B2. Day/Night home nursing	125	34.15	2	50	40	3
B3. Daily care	91	24.86	3	57	62.64	1
Safety needs
C1. Improving living environment	301	82.24	1	172	57.14	1
C2. Establishing an emergency call system	287	78.42	2	0	0	7
C3. Community emergency rescue	281	76.78	4	82	29.18	6
C4. Establishing a green emergency channel	284	77.6	3	97	34.15	5
C5. Two-way referral service	266	72.68	5	115	43.23	3
C6. Guidance on preventing accidental injury	246	67.21	7	123	50	2
C7. First aid and skills guidance	249	68.03	6	87	34.94	4
Health education
D1. Guidance on disease monitoring skills	332	90.71	1	221	66.57	1
D2. Guidance on psychological well-being monitoring	254	69.4	5	151	59.45	3
D3. Caregiver education	249	68.03	6	138	55.42	5
D4. Chronic disease prevention and control	282	77.05	3	130	46.1	6
D5. Medication guidance	254	69.4	5	117	46.06	7
D6. Exercise guidance	260	71.04	4	149	57.31	4
D7. Diet and nutrition counseling	287	78.42	2	174	60.63	2
Rehabilitation training and guidance needs
E1. Delay degeneration training in cognitive function, memory function, and learning ability	156	42.62	1	53	33.97	5
E2. Rehabilitation exercise for daily life function	82	22.4	3	45	54.88	1
E3. Guidance on proper use and maintenance of medical auxiliary devices	83	22.68	2	44	53.01	2
E4. Rehabilitation training of motor function	73	19.95	4	35	47.95	4
E5. Rehabilitation training of language function	49	13.39	5	25	51.02	3
Respect and self-development
F1. Respect	320	87.43	1	266	83.13	1
F2. Organize supportive teams for elderly with the same disease	173	47.27	4	45	26.01	4
F3. Information about participating in social activities	184	50.27	3	74	40.22	2
F4. Guidance of choosing the suitable activities	214	58.47	2	85	39.72	3
F5. Introduction to re-employment for the elderly	78	21.31	5	18	23.08	5

Multivariate logistic regression analysis assignment table

Independent variable	Assignment
Gender (X1)	“Male” = 1, “Female” = 2
Monthly income (X2)	“<1000 CNY” = 1, “>1000–2000 CNY” = 2, “>2000–3000 CNY” = 3, “>3000 CNY” = 4
Methods of medical payment (X3)	“Self-funded” = 1, “Urban worker basic medical insurance” = 2, “Urban resident basic medical insurance” = 3, “New rural cooperative medical insurance” = 4
Lack of exercise (X4)	“Exercise” = 1, “Lack of exercise” = 2
Re-hospitalization frequency (X5)	“0 time” = 1, “1–3 times” = 2, “≥4 times” = 3
Re-hospitalization duration (X6)	“Never” = 1, “Less than 3 months” = 2, “3–6 months” = 3, “More than 6 months” = 4
Caring intention (X7)	“Home-based” = 1, “Community-based” = 2, “Institution-based” = 3
ADL score (X8)	“0–20” = 1, “21–40” = 2, “41–60” = 3, “61–99” = 4, “100” = 5
Healthcare needs (Y)	“Low-demand group” = 1, “High-demand group” = 2

Comparison of demographic and socioeconomic characteristics between high- and low-demand groups (N = 366)

Variables	Low-demand group	High-demand group	χ2	P value
Age (years)			0.005	0.997
60–69	101	112
70–79	49	55
≥80	23	26
Gender			6.44	0.011*
Male	65	98
Female	108	95
Nationality			0.282	0.595
Han Chinese	153	174
Other ethnic minorities	20	19
Degree of education			1.851	0.604
Illiteracy	22	24
Primary school	55	57
Junior high school	53	52
High school and above	43	60
Marital status			0.662	0.416
Married	131	153
Widowed or divorced	42	40
Living conditions			1.199	0.753
Living alone	21	18
Living only with spouse	60	68
Living with children	85	96
Others (live with grandchildren, etc.)	7	11
Monthly income (yuan)			10.457	0.015*
<1000	28	37
1000–1999	45	72
2000–2999	71	50
>3000	29	34
Methods of medical payment			10.331	0.016*
Urban worker basic medical insurance	114	126
Urban resident basic medical insurance	16	37
New rural cooperative medical insurance	39	28
Commercial medical insurance	0	0
Self-funded	4	2

Multivariate logistic regression analysis of the influencing factors in high- and low-demand groups

Independent variable	Regression coefficients (β)	Standard error	Wald value	P value	OR value	95% CI of OR
						Lower bound	Upper bound
Gender	–0.576	0.234	6.048	0.014*	0.562	0.355	0.89
Monthly income	–0.373	0.146	6.541	0.011*	0.689	0.518	0.917
Method of medical payment (self-paying) (Reference)			7.976	0.047*
Method of medical payment (urban workers)	–0.365	0.97	0.142	0.707	0.694	0.104	4.646
Method of medical payment (urban residents)	0.82	0.362	5.116	0.024*	2.27	1.116	4.62
Method of medical payment (new rural cooperative)	1.004	0.439	5.22	0.022*	2.729	1.153	6.455
Lack of exercise	0.912	0.416	4.804	0.028*	2.489	1.101	5.624
Re-hospitalization frequency	0.573	0.463	1.536	0.215	1.774	0.716	4.394
Re-hospitalization duration	–0.07	0.454	0.024	0.877	0.932	0.383	2.269
Caring intention (home-based) (Reference)			8.779	0.012*
Caring intention (community-based)	0.646	0.293	4.862	0.027*	1.908	1.074	3.388
Caring intention (institution-based)	1.203	0.43	7.828	0.005*	3.33	1.434	7.733
ADL score	–0.318	0.156	4.155	0.042*	0.728	0.536	0.988
Constant	1.18	1.044	1.278	0.258	3.254

Comparison of risk factors in high- and low-demand groups (N = 366)

Risk factors	Low-demand group	High-demand group	χ2	P value
Smoking			0.007	0.935
No	151	169
Yes	22	24
Drinking alcohol			0.952	0.329
No	157	169
Yes	16	24
Lack of exercise			8.191	0.004*
No	163	164
Yes	10	29
Poor medical practices			0.522	0.47
No	144	155
Yes	29	38