Achievements and challenges in health management for aged individuals in primary health care sectors: a survey in Southwest China

Li Li,Shili Liu,Yong Chen,Rui Zhang,Mei Wang,Haoyue Deng,Wei Xing,Hai Lin,Ying Li,Shengxiang Liang,Geng Wang

doi:10.1186/s12889-020-8210-2

Li Li, Shili Liu + Show 9 more

Open Access

https://doi.org/10.1186/s12889-020-8210-2

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Abstract

BackgroundChina has rapidly transformed into an ageing nation and will be one of the countries with the highest percentage of aged people in 2050. Healthcare management for the aged (HMA) in basic public health service (BPHS), which is delivered by lay healthcare workers (LHWs) in primary health care (PHC) sectors, is an important strategy to address the healthcare challenges that have resulted from ageing in China since 2009. This survey aimed to understand the achievements made and challenges faced by HMA in Southwest China.MethodsA multilevel stratified random and consecutive sampling method was used to select study places and participants respectively, and mixed research methods were used to collect data from the aged individuals, LHWs and leaders in PHC sectors. SPSS 21.0 was used for data analysis.ResultsSeven hundred seventy-two surveys with aged people (over 60 years old), 16 focus group discussions (FGDs) with 96 aged people, and 32 in-depth interviews with 16 LHWs and 16 leaders were completed in PHC sectors. More than 85% of aged individuals had knowledge and utilization of HMA, and over 94% of these respondents were satisfied with HMA. Meanwhile, challenges in HMA delivery included weakness (unmet items and lack of appropriate assessment indicators) in HMA design, low capacity of PHC sectors and competency of LHWs to deliver HMA, poor health literacy of aged individuals, insufficient funds and a lack of multi-sector cooperation.ConclusionsThough significant achievements in HMA were observed, this study highlighted the challenges in further quality improvement of HMA delivery program in Southwest China. The “older-person-centered and integrated care” model provided a good theory to improve the quality of HMA by reinforcing the needs-based HMA design, building a comprehensive assessment strategy, improving the capacity of PHC sectors and the LHWs’ competency, and strengthening multi-sector cooperation.

Highlights

China has rapidly transformed into an ageing nation and will be one of the countries with the highest percentage of aged people in 2050
Basic health insurance covered almost all of the aged individuals, while nearly 80% lived close to primary health care (PHC) sectors
There are many challenges, one is that it is hard for us to achieve the required the rate of Healthcare management for the aged (HMA), for example, there are 6000 elderly in this area, at least 65% of them should take health check-up (HC) items according to the requirement because the policy for the elderly to take HMA is optional, but we may achieve just around 40% and cannot met the requirement which directly impacts on funding for HMA and our income (LHWs on HMA in Community Health Center (CHC))

Summary

Introduction

China has rapidly transformed into an ageing nation and will be one of the countries with the highest percentage of aged people in 2050. Healthcare management for the aged (HMA) in basic public health service (BPHS), which is delivered by lay healthcare workers (LHWs) in primary health care (PHC) sectors, is an important strategy to address the healthcare challenges that have resulted from ageing in China since 2009. This survey aimed to understand the achievements made and challenges faced by HMA in Southwest China. Ageing has become a pervasive social problem in China as the Chinese “become aged before rich”, the lack of preparation for an aging society, planning for the health needs of the elderly in China, challenges the health and social care system of this country [4]

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