老年人口长期护理需求及影响因素分析--基于上海调查数据的实证分析

老年人长期护理问题已经成为当前我国重要的社会问题之一。文章基于上海市28个社区的调查数据,利用相关定量模型,实证分析上海老年人对护理服务的需求、满意情况及其影响因素。研究发现：不仅老年人健康状况、长期护理费用对老年人口长期护理需求有显著影响,更为重要的是长期护理的资源供给情况已经成为制约老年长期护理发展的关键因素。明确老年人口长期护理服务的责任主体,建立以老年护理需求为导向的评估体系,构建政府主导、社会多元主体参与的长期护理服务体系成为应对人口老龄化风险的有效路径。     

国外老年长期护理产业发展及对中国的启示

人口快速老龄化使老年长期护理成为国际社会关注的焦点。通过对国外老年长期护理产业的历史回顾及现状分析,发现需求旺盛和生活形态变迁正刺激老年长期护理产业发展及有助于拉动就业和带动地区经济增长;美国、日本的发展进程表现出当前老年长期护理产业陷入了人力资源短缺、护理成本高和质量差等困境。我国应借鉴发达国家的经验与教训,通过构建老年长期护理保障制度、运用灵活的资金筹措机制和建立多元化照护服务体系等,快速发展和完善老年长期护理产业,在满足老年人及其家庭需要的同时,作为一项新型产业开辟劳动力市场和拉动地区经济增长。     

Health, widowhood, and family support in the North and South Pacific: a comparative study

This paper compares the impacts of health and widowhood on the level of support received by elderly women living in small island communities within the Philippines and Fiji. Using a theoretical perspective of ongoing reciprocal exchange as opposed to altruistic support within household economies, this paper reviews the impacts of disability and economic contributions on the level of support an elderly female receives. It is hypothesized that as the health of the widow declines her access to care will also diminish due to an inability to contribute to the household economies of the extended family. This paper extends existing work on health and family support of widowed females in the developing world by performing a cross-national comparative analysis as well as by explicitly testing the assumptions of altruism that are a central assumption of most models of long-term care in underdeveloped nations.     

Health expectancies in Japan: gender differences and policy implications for women

Based on prospective observation of elderly people in the community in Japan, we compared the time-course of development and progression of physical disability between women and men. Men experienced disability at a younger age and at a faster rate than did women. The duration of time spent with disability in women was twice as long as in men. Consequently, women consume about two-thirds of the total resources of formal caregiving services in Japan. Women in Japan are increasingly educated, postponing marriage to higher ages, and less likely to care for parents in the home. Given these changes in family structure and social norms, the capacity for informal family caregiving has decreased dramatically. A recently enacted national long-term care insurance system may further change the picture of caregiving.     

Factors associated with long-term benzodiazepine use among elderly women and men in Quebec

The goal of this study was to compare factors associated with long-term benzodiazepine use by elderly women and men (n = 1701) who participated in the Quebec Health Survey (QHS). Data from the 1998 QHS were linked with data from the administrative files of the Régie de l'assurance maladie du Québec. Results showed that elderly women were more at risk than men for long-term benzodiazepine use. Results of the multivariate logistic regression did not show a significant difference between women and men on any of the risk factors studied. Other factors such as elderly and physician attitudes deserve further study to explain differences in long-term benzodiazepine use between elderly women and men.     

Factors Associated with Long-Term Benzodiazepine Use Among Elderly Women and Men in Quebec

ABSTRACT

The goal of this study was to compare factors associated with long-term benzodiazepine use by elderly women and men (n = 1701) who participated in the Quebec Health Survey (QHS). Data from the 1998 QHS were linked with data from the administrative files of the Régie de l'assurance maladie du Québec. Results showed that elderly women were more at risk than men for long-term benzodiazepine use. Results of the multivariate logistic regression did not show a significant difference between women and men on any of the risk factors studied. Other factors such as elderly and physician attitudes deserve further study to explain differences in long-term benzodiazepine use between elderly women and men.     

台湾地区人口老龄化下长期护理政策及走向

1993年台湾地区65岁以上老年人口占总人口比例为7%,成为我国最早进入人口老龄化的地区之一。伴随着老年慢性病盛行、老年人生活方式的变化以及家庭照料负担日益沉重,老年人长期护理服务开始转变为较为严重的社会风险。为此,台湾推行了一系列长期护理服务政策,包括居家护理、社区护理以及护理产业的商业化运作等。这些政策取得一些积极的社会效果,但也存在着"有效需求"不足、长期护理服务投资意愿不强、福利成分丧失等问题。为了妥善解决老年人长期护理服务难题,台湾正在启动长期护理保险的立法计划并组建筹备小组展开前期的研究与论证工作。     

The Important Things in the Life of Older People: Elderly Women in Social Houses and Home Care

The purpose of the article is to analyze the aging experiences of elderly women in Estonia and the factors influencing them. The assessments of two groups using social services are compared—the elderly living in Tallinn’s social houses and the elderly receiving care at home. From February to August 2011, a total of 80 elderly women were interviewed. Inhabitants of social houses find that their old age is satisfying more often (65% of the inhabitants of social houses and 40% of the people in home care). Many home care clients were convinced that it is best to spend old age among loved ones and in a familiar environment. Those living at home have many difficulties, which is why 20% of them are on a waiting list to go to a social house. Home services should include services with which the inhabitants of social houses are very satisfied.     

Can concern for the long-term care of older parents explain son preference at birth in India?

This study examines whether concern for the long-term care of older parents is the primary reason for son preference in India. Controlling for important socioeconomic factors that are believed to affect son preference, we find that concern for long-term care is the principal cause of son preference in India. Sons serve as the primary caregivers to elderly parents, while daughters are mostly engaged in caring for parents-in-law. This trend is more acute in rural than in urban areas. Our study also finds a strong implication of the filial relationship for the long-term care of elderly parents.     

长期失能老人照料决策研究——以个人资本为视角

本文运用半结构式访谈的研究方法,从需要长期照料即长期失能老人的视角出发,引入林南的个人资本理论来分析老人的长期照料决策。通过对武汉市和广州市13名居家和21名居住在养老院的长期失能老人的访谈,发现对于城市长期失能老人的照料决策而言：第一,长期照料决策受到资本不平等的影响;第二,长期照料决策受到资源收益最大化的影响。     

我国高龄老人长期护理需求测度及保障模式选择

伴随着人口老龄化,我国老年人口高龄化现象日渐突出。高龄老人失能概率高．长期护理需求大．是老年人口中的脆弱群体。本文基于MarkOV多状态转移模型．对我国高龄老人长期护理需求进行量化预测。结果表明．2010--2050年我国失能高龄老人人口规模将从860．47万人激增至4764．52万人．高龄老人长期护理费用从1020．47亿元攀升至5650149亿元。昂贵的长期护理费用致使传统以家庭为主体的长期护理模式难以为继．为有效缓解未来高龄老人长期护理财务压力,满足高龄老人长期护理服务需求,发展长期护理保险与提升长期护理服务水平成为契合我国现实国情的政策方略．     

Older Women's Health and Its Impact on Wealth

As many elderly women tend to outlive their spouses, there is a growing population of unmarried elderly women. Unmarried women are worse off than married women both financially and physically. A question that has not been answered is whether and how the relationship between health and wealth differs across elderly women's marital status. Do the negative impacts of health problems cause more serious financial consequences for unmarried elderly women than married women? Using the five waves of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) from 1993 to 2002, this question is empirically investigated. Results indicate that severe chronic conditions result in 4 to 10% greater wealth depletion for unmarried women than married women. This finding calls for heightened awareness of the negative financial consequences of health problems and also calls for increased lifetime earning potential, reconsideration of women's retirement benefits, and greater attention to preventive care.     

Discrimination Against Older Women in Health Care

Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.     

Functional Health of Older Women:

Many elderly women need long-term care assistance to help them remain independent. A stresscoping framework was used to test predictors of functional health in a sample of 110 community- residing, older women. The causal relationships among hardiness, self-esteem, social support, stress, coping, and service utilization were examined. Results from the regression analyses indicated that 36% of the variance in physical and independent health was explained by hardiness, stress, coping, and service utilization and 52% of the variance in psychosocial health was explained by hardiness, selfesteem, stress, and coping. The discussion is orgaruzed according to the stress-coping paradigm and explicates the various relationships found.     

老年长期护理需求及其影响因素分析——基于苏皖两省调查的比较研究

随着我国人口的快速老龄化,老年人长期护理已经由过去家庭承担的事务演变成现在必须正视的社会问题。本文通过对安徽、江苏两省的调查,描述了老年人生活与健康状况以及长期护理需求的差异性,分析了老年长期护理需求意愿的影响因素。研究发现,地区、户口、教育程度、无子女、有退休金、洗澡有困难、半身不遂、女儿或女婿照料8个因素对老年长期护理需求具有显著的影响,但是相对于欠发达地区而言,这些因素对经济相对发达地区的老年人长期护理服务需求的影响度要小。在此分析基础上提出了推动与完善我国老年长期护理服务体系的一些政策建议。     

Elderly Women,Exercise and Healthy Aging

The persistent view of old age as a time for accepting an inevitable decline in health and vigour continues to shape the exercise patterns of elderly women, despite rapidly accumulating evidence that what has formerly been perceived as "normal aging" is, in part, the deficit of disuse and inactivity. While the risks associated with increased physical activity are not to be overlooked, more attention is being given to the overwhelming benefits of adequate exercise for the elderly, both in terms of short and long-term contributions to enhanced physical, social and emotional well-being. Conditioned to believe that being old and female is a sort of "double jeopardy" requiring restraint in physical activity, elderly women have been slow to respond to the new view of exercise as a crucial part of healthy aging. So long as elderly women do not readily perceive the advantages to be accrued from regular exercise patterns and do not believe they are capable of vigourous physical activity, government policies and plans to disseminate information about health and exercise are unlikely to generale large scale action toward health promotion.     

农村妇女对子女的效用预期与其男孩偏好的关系

文章利用中国人民大学2010年相关调查数据从经济、照料和文化三个方面分析了我国农村地区妇女对孩子未来效用的总体预期和分性别预期,以及这种预期效用的性别差异与人们的强性别偏好之间的关系,并得出以下结论:随着经济社会的发展和人口流动的频繁,人们目前对子代的养老效用预期在经济和居住方面已经很低,但在生病照料和赡养、传宗接代方面期望依然很高;人们对男孩和女孩的预期各有侧重,依然体现了传统的"男主外,女主内"的性别认知;人们对孩子效用预期的性别差异与人们的性别偏好呈显著正相关,尤其体现在老年照料、赡养责任和传宗接代等方面,代际经济支持已经不再是影响人们男孩偏好的重要原因。     

Public Policy,Health Care and Older Women

For the first time in history, long life has become a problem. The most serious problem facing the older generation is the availability and affordability of health care. While the life expectancy of both men and women cbntinues to increase, the older population of the U.S. is becoming increasingly feminine. In the last two decades there has been a dramatic fall in poverty among the aged, yet for many elderly persons and especially older women, Social Security benefits barely keep them above the poverty level. Access to medical care has improved with Medicaid and Medicare, but not to the extent the aging population had anticipated. Proposals for universal health care have been put forth by politicians, legislators and professional organizations, some of which acknowledge the unique health problems of aging women while others are discriminatory to the aged in general and women in particular. Many believe women must assert themselves if their health care needs are to be adequately and fairly addressed. To this end, more women than ever are becoming involved in the political process, running for and being elected to local, state and national offices. It is anticipated that these women will be sensitive to the health care needs of older women and put forth efforts to develop and implement policies which address these needs.