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. 2020 Mar 17;20(1):338.
doi: 10.1186/s12889-020-8210-2.

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

Li Li  1   2 , Rui Zhang  1 , Yong Chen  1 , Haoyue Deng  1 , Shili Liu  1 , Geng Wang  1 , Mei Wang  1 , Shengxiang Liang  1 , Wei Xing  1 , Hai Lin  3 , Ying Li  4
Affiliations

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

Li Li et al. BMC Public Health. .

Abstract

Background: 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.

Methods: A 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.

Results: Seven 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.

Conclusions: Though 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.

Keywords: Aged individuals; Basic public health service; China; Health management; Lay healthcare worker.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Knowledge and utilization of, and satisfaction with HMA. This figure presents the percentage of the aged had knowledge on and utilization of, and satisfaction with all healthcare management for the aged (HMA) items, including lifestyle evaluation and health assessment (LE and HA), health check-up (HC), auxiliary exam (AE) and health guidance (HG)
Fig. 2
Fig. 2
Flow chart of study region selection
See this image and copyright information in PMC

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