Choice Preference of Middle-Aged and Elderly People on Integrated Medical Services and Elderly Care Model: A Cross-Sectional Study.

Facing the increasingly severe aging situation, China has started to implement the "integrated medical services and elderly care (IMSEC)" policy, which covers a variety of IMSEC models. However, there is currently little research on middle-aged and elderly people's choice preference for these IMSEC models and their associated factors. Through the face-to-face questionnaire method, the choice preference of middle-aged and elderly people aged 45 years and over in Zhejiang Province, China, to the IMSEC model is explored. Through the multinomial logistic regression model, the influencing factors of choice preference are analyzed. A total of 1034 people are included in 2022. Their choice preference for the 4 major types of IMSEC models are Home IMSEC model (48.07%), Community IMSEC model (23.79%), Institutional IMSEC model (21.76%), and Internet Plus IMSEC model (6.38%). "C1. Home elderly care and contracted with a family doctor" is the most chosen subtype, accounting for 34.53%. The rural elderly are more likely to choose "Home IMSEC model" (OR(95%CI) = 2.977(1.343-6.601)). Elderly people with relatively large life care needs are more likely to choose "Institutional IMSEC model" (OR(95%CI) = 1.114(1.042-1.190)). Moreover, age, education, and self-reported health status are also influencing factors of choice preference. The government should focus on promoting the development of the "Home IMSEC model" and increase the promotion of "Internet Plus IMSEC model." In addition, the life care service capacity and spiritual comfort capacity of IMSEC institutions, as well as the medical service capacity of the community, need to be enhanced.

Home/Community-Based Medical and Elderly Care Services Utilization in China: A Cross-Sectional Study from the Middle-Aged and Elderly Population.

Few studies have analyzed the acceptance of home/community-based medical and elderly care services in China. Therefore, we conducted a cross-sectional study to describe the acceptance of five services among people aged ≥ 45 years in the China mainland, and their influencing factors. The data were obtained from the database China Health and Retirement Longitudinal Study 2018. For each service, a binary logistics regression was adopted. A total of 9719 people were included, of whom 20.12% received services. The numbers of recipients (acceptance rates) of the five services, namely, comprehensive aged care services, regular physical examinations, onsite visits, health management, and entertainment, were 107 (1.10%), 1640 (16.87%), 323 (3.32%), 156 (1.61%), and 245 (2.52%), respectively. About 4% of people had received two or more services. The elderly aged 65-74 and those who were satisfied with the local medical services had higher acceptance of services. Urban hukou having health insurance, two or more chronic diseases, provincial economic welfare, and social welfare were positively associated with the acceptance of regular physical examination services. It is suggested that the government should gradually improve satisfaction with local medical services, and pay more attention to the needs of elderly people aged 65-74 for all kinds of home/community-based medical and elderly care services.

Evaluation of the Medical Resource Allocation: Evidence from China.

Medical resource allocation is an increasingly crucial issue. It is vital to understand residents' (people living in the local area) evaluation of it. This study explores residents' evaluation of medical resource allocation and its determinants with the dimensions of medical resource adequacy, balance, publicness, and accessibility. We used data from the China General Social Survey (CGSS). Binary logistic regression models were constructed from the four dimensions separately, and we compared the differences among them. The study's results showed that accessibility and publicness are the highest and lowest dimensions of residents' evaluation, respectively. The high evaluation of social equity may be a positive contributor to a higher evaluation of publicness and accessibility. The central region residents had the lowest evaluation of adequacy (OR = 0.697, p = 0.010) and balance (OR = 0.642, p = 0.008). To sum up, perceived social equity, social trust, and social class are crucial factors. Based on the results, the government should strengthen the supervision of the medical market, increase financial support for the health field in the central region, and establish a multi-level medical security system that may help optimize the allocation.

Self-medication and its typology in Chinese elderly population: A cross-sectional study.

Purpose: This paper aims to evaluate the prevalence of self-medication and its associated factors among the Chinese elderly. Also, according to whether the elderly communicate with doctors (no matter before or after self-medication), we aimed to categorize self-medication and explore the associated factors. Methods: It was a cross-sectional study. Data were derived from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS). According to whether communicate with doctors or not, self-medication was reclassified as "self-medicate and NOT communicating with a doctor," and "self-medicate and communicate with a doctor." A binary logistic regression was used to identify which elderly were more likely to self-medicate, and a multinomial logistic regression was applied to explore the associated influencing factors of self-medication classifications. Results: A total of 17,445 individuals aged ≥45 years were enrolled. The prevalence of self-medication was 58.60%. Self-medication was strongly associated with sex, education level, pension, self-reported general health status, chronic illness, satisfaction with local medical services, and three province-level socioeconomic welfare variables. About 19.64% of self-medication populations had communicated with a doctor. Higher education level and younger age were significantly associated with a higher probability of "self-medication and communication with a doctor." Conclusion: The prevalence of self-medication among the Chinese elderly is increasing over the year. Health education on appropriate medication use targeting elder adults with low education levels is highly recommended. The typology of self-medication and its factors are new research entry points and could be meaningful for future studies.