国家长期护理失能等级评估标准与上海市老年照护统一需求评估标准一致性研究OA北大核心CSTPCD
Research on the consistency between the national assessment standards for disability grade in long-term care and the unified assessment standards for elderly care needs in Shanghai
目的 比较国家长期护理失能等级评估标准(以下简称"国家标准")与上海市老年照护统一需求评估标准(以下简称"上海标准")的对应程度,提出2套标准衔接的建议.方法 对国家标准与上海标准的指标内容、评估结果进行比较.选取2023年1-5月上海市长期护理保险评估的179 141条数据,根据国家标准和上海标准对数据进行重新评估,标化数据并计算不同标准下日常生活活动能力、认知能力、感知觉与沟通能力维度的评分,使用四分位数间距、构成比折线图、气泡图等比较采用2套标准计算得出的结果的一致性,并将采用2套标准计算得出的失能情况进行对比.结果 上海标准涵盖了国家标准的全部指标维度.2套标准在日常生活活动能力维度的评分分别为53.5(35.0,62.5)分、55.0(35.0,65.0)分,在感知觉与沟通能力维度的评分分别为75.0(75.0,100.0)分、83.3(66.7,91.7)分,2个维度在各分数段的构成比分布接近,构成比趋势变化基本吻合.2套标准在认知能力维度的评分分别为48.0(31.0,63.0)分、38.8(17.5,61.3)分,存在一定差异.在失能情况方面,上海标准计算得出的失能情况以轻、中度失能为主,国家标准计算得出的失能情况以中、重度失能为主.结论 上海标准与国家标准的总体对应度较好,在日常生活活动能力和感知觉与沟通能力维度评分的一致性较高,在认知能力维度评分存在一定差异.
Objective To compare the consistency between the National Standards for Disability Grade Assessment in Long-term Care and the Unified Needs Assessment Form for Elderly Care in Shanghai(hereinafter referred to as national standards and Shanghai standards),and propose suggestions for bridging the two standards.Methods Indicators and assessment grades from the two standards had been compared.A total of 179,141 pieces of data from the Shanghai standards from January to May 2023 were included,and consequently,these data were re-evaluated according to the two standards.Using InterQuartile Range,the consistency of Activities of Daily Living(ADL),cognitive ability,perceptual ability,together with communication ability were compared and presented in ratio line charts and bubble charts.Further,the disability situations obtained by calculating the same data in the two standards were analyzed.Results The results showed that the Shanghai standards covered all indicator dimensions of the national standards.The quartiles of the two sets of standards in the ADL dimension were 53.5(35.0,62.5)and 55.0(35.0,65.0),respectively.The quartiles in the perception and communication ability dimensions were 75.0(75.0,100.0)and 83.3(66.7,91.7),respectively.The data distribution of the 2 dimensions in terms of the proportion in each score range is close,and the trends of proportion are basically in line with each other.However,the quartiles of the two standards in the cognitive ability dimension were 48.0(31.0,63.0)and 38.8(17.5,61.3),and the data showed differences between the two standards.For example,the disability situations calculated by Shanghai standards were mild and moderate in majority,while the disability situations calculated by national standards were relatively moderate and severe.Conclusion The two standards are consistent in general with high consistency in terms of ADL and perceptual and communication skills dimensions,and differences in cognitive abilities dimensions still exist.
万铃珊;张蕴伟;薛佳;曹宜璠;丁汉升
上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海 200031
预防医学
长期护理保险长期护理失能等级评估标准老年照护统一需求评估一致性研究
long-term care insurancedisability grade in long-term carethe unified assessment standards for elderly care needsthe consistency study
《健康发展与政策研究》 2024 (002)
85-90,103 / 7
国家自然科学基金(72074152)
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