山西省居家老年人长期护理服务需求的调查研究

doi:10.3761/j.issn.0254-1769.2026.16.013

摘要/Abstract

摘要：

目的识别并分析山西省居家老年人长期护理服务的需求属性及其随失能等级演变的规律，为完善长期护理保险服务清单及优化护理资源配置提供参考。方法采用便利抽样法，于2025年10—12月选取山西省太原市、临汾市、晋城市、长治市4个长护险试点城市的310例居家老年人为调查对象，采用自行编制的基于Kano模型的长期护理保险服务需求问卷进行调查，通过属性划分、Better-Worse系数分析和重要度矩阵识别不同失能等级居家老年人的需求属性及改进优先顺序。结果共发放问卷310份，回收有效问卷301份。山西省不同失能等级居家老年人的需求呈现由社会支持向医疗护理保障转化的趋势，基本正常居家老年人以无差异属性需求为主，轻度失能居家老年人必备属性需求明显扩张至13项，中、重度失能老年人以期望属性需求为主，疾病管理与风险防控需求明显增长。结论山西省长期护理保险服务项目优化需基于失能等级采取差异化策略，确保中重度失能群体必备型服务的稳定供给，重点开发轻度失能群体的魅力型和期望型服务，以最大化提升山西省居家老年人的护理服务满意度和生活质量。

关键词: 长期护理保险, 护理服务需求, 老年人, 慢性病护理

Abstract:

Objective To identify and analyze the demand attributes of long-term care services for home-based elderly in Shanxi Province and the patterns of their evolution with disability levels，providing references for improving the long-term care insurance service catalogue and optimizing home care resource allocation. Methods A convenience sampling method was adopted to select 310 home-based elderly from 4 long-term care insurance pilot cities（Taiyuan，Linfen，Jincheng，and Changzhi） in Shanxi Province from October to December 2025. A self-developed Kano model-based long-term care service demand questionnaire was used for the survey. Demand attributes and improvement priorities for the elderly at different disability levels were identified through attribute classification，Better-Worse coefficient analysis，and importance matrix. Results A total of 310 questionnaires were distributed，and 301 valid questionnaires were collected. The demands of home-based elderly showed a shifting trend from social support to medical-nursing security as disability intensified. The normal elderly group primarily reported indifferent attributes；the mildly disabled showed a significant expansion of must-be attributes（13 items）；the moderately/severely disabled groups were dominated by one-dimensional attributes，with a surge in demand for disease management and risk prevention. Conclusion The optimization of long-term care insurance service should adopt differentiated strategies based on disability levels. It is crucial to ensure the stable supply of must-be services for the moderately to severely disabled while prioritizing the development of attractive and one-dimensional services for the mildly disabled to enhance nursing satisfaction and life quality.

Key words: Long-Term Care Insurance, Care Service Demand, Aged, Chronic Disease Care

李旻玥, 苟蒙雨, 贺利平, 郭小燕. 山西省居家老年人长期护理服务需求的调查研究[J]. 中华护理杂志, 2026, 61(16): 2253-2260.

LI Minyue, GOU Mengyu, HE Liping, GUO Xiaoyan. Investigation on long-term care service needs of home-based elderly in Shanxi Province[J]. Chinese Journal of Nursing, 2026, 61(16): 2253-2260.

图/表 3

表1 Kano模型需求属性划分表

Table 1 Demands attribute division of the Kano model

表2 调查对象的一般资料（n=301）

Table 2 Demographic characteristics of survey subjects（n=301）

表3 老年人长期护理服务需求属性归类

Table 3 Classification table of attributes of long-term care service demands for the elderly

参考文献 23

[1]	龚秀全, 庄晨. 中国老年人失能趋势与健康促进策略研究:基于年龄—时期—队列的视角[J]. 人口与经济, 2024(5):36-50.
	Gong XQ, Zhuang C. Disability trends and health promotion strategies of the elderly in China:based on the age-period-cohort model[J]. Popul Econ, 2024(5):36-50.
[2]	郎杰燕. 山西省长期护理保险试点的推进与优化之路[J]. 护理研究, 2025, 39(5):843-846.
	Lang JY. Promotion and optimization of long-term care insu-rance pilot in Shanxi Province[J]. Chin Nurs Res, 2025, 39(5):843-846.
[3]	山西省卫生健康委员会. 我省全面推行国家统一长期护理失能等级评估标准[EB/OL].(2026-02-09)[2026-03-13]. https://wjw.shanxi.gov.cn/xwzx/szyw/202602/t20260209_10058969.shtml.
	Shanxi Provincial Health Commission. Comprehensive imple-mentation of the national unified long-term care disability le-vel assessment standards in our province[EB/OL].(2026-02-09)[2026-03-13]. https://wjw.shanxi.gov.cn/xwzx/szyw/202602/t2026-0209_10058969.shtml.
[4]	张嘉丽, 陈虹秀, 王艺霖, 等. 49个长期护理保险制度试点城市评估失能等级和长期照护需求的现状[J]. 中华护理杂志, 2025, 60(19):2384-2390. DOI
	Zhang JL, Chen HX, Wang YL, et al. A comparative study on the current status of disability assessment and long-term care needs assessment in 49 pilot cities of the long-term care insurance system[J]. Chin J Nurs, 2025, 60(19):2384-2390. DOI
[5]	潘诗悦, 储静, 裴艳, 等. 基于23个试点省市的长期护理保险非基本生活照护类服务项目的问题分析及优化策略[J]. 护理研究, 2025, 39(9):1409-1415.
	Pan SY, Chu J, Pei Y, et al. Problem analysis and optimization strategies for non-basic life care service items of long-term care insurance based on 23 pilot provinces and cities[J]. Chin Nurs Res, 2025, 39(9):1409-1415.
[6]	Zhao XJ, Zhang J, Yang MY, et al. Preferences for electronic health information support concerning chemotherapy adverse reactions among young and middle-aged breast cancer patients based on the Kano model[J]. Support Care Cancer, 2026, 34(3):218.
[7]	Hao SJ, Hong YH, Xu ML, et al. Exploring service demands of community-embedded elderly care based on the Kano model:a cross-sectional study in Hefei,China[J]. BMC Geriatr, 2026, 26(1):337. DOI
[8]	Chen MC, Hsu CL, Lee LH. Service quality and customer sati-sfaction in pharmaceutical logistics:an analysis based on Kano model and importance-satisfaction model[J]. Int J Environ Res Public Health, 2019, 16(21):4091. DOI URL
[9]	国家统计局. 第七次全国人口普查公报(第五号):人口年龄构成情况[J]. 中国统计, 2021(5):10-11.
	National Bureau of Statistics. Bulletin of the seventh national census (No.5):population age composition[J]. China Stat, 2021(5):10-11.
[10]	国家医疗保障局. 关于印发《长期护理保险失能等级评估管理办法(试行)》的通知[EB/OL].(2023-12-01)[2026-03-13]. https://www.gov.cn/zhengce/zhengceku/202312/content_6920626.htm.
	National Healthcare Security Administration. Notice on Print-ing and Distributing the “Measures for the Administration of Long-Term Care Insurance Disability Level Assessment(Trial)”[EB/OL].(2023-12-01)[2026-03-13]. https://www.gov.cn/zheng-ce/zhengceku/202312/content_6920626.htm.
[11]	国家医疗保障局. 关于印发《长期护理保险服务管理文书(2026年版)》的通知[EB/OL].(2025-12-01)[2026-03-13]. http://www.nhsa.gov.cn/art/2025/12/1/art_104_18899.html.
	National Healthcare Security Administration. Notice on Issuing the “Long-Term Care Insurance Service Management Do-cuments(2026 Edition)”[EB/OL].(2025-12-01)[2026-03-13]. http://www.nhsa.gov.cn/art/2025/12/1/art_104_18899.html.
[12]	国家医疗保障局. 关于印发《国家长期护理保险服务项目目录(试行)》的通知[EB/OL].(2025-09-18)[2026-03-13]. https://www.gov.cn/zhengce/zhengceku/202509/content_7042325.htm.
	National Healthcare Security Administration. Notice on Print-ing and Distributing the “National Long-Term Care Insurance Service Item Catalog(Trial)”[EB/OL].(2025-09-18)[2026-03-13]. https://www.gov.cn/zhengce/zhengceku/202509/content_70-42325.htm.
[13]	袁丁, 李贝, 张春瑾, 等. Kano模型在护理领域应用的研究进展[J]. 中国护理管理, 2024, 24(9):1432-1437.
	Yuan D, Li B, Zhang CJ, et al. Research progress on appli-cation of Kano model in the field of nursing[J]. Chin Nurs Manag, 2024, 24(9):1432-1437.
[14]	房紫如, 赵文利, 苗晓慧, 等. 介入手术室护士培训需求调研与分析[J]. 中华护理教育, 2024, 21(12):1482-1489.
	Fang ZR, Zhao WL, Miao XH, et al. Investigation and analysis of training needs of nurses in interventional operating room[J]. Chin J Nurs Educ, 2024, 21(12):1482-1489.
[15]	钟凯颖, 孙龙凤. 基于Kano模型的失能老年人长期照护需求研究进展[J]. 中华护理杂志, 2022, 57(3):368-373. DOI
	Zhong KY, Sun LF. Research progress on long-term care needs of disabled elderly based on Kano model[J]. Chin J Nurs, 2022, 57(3):368-373. DOI
[16]	刘丽, 张帅, 胡秀英. 四川省老年人护理需求及服务的调查研究[J]. 中华护理杂志, 2023, 58(19):2339-2344. DOI
	Liu L, Zhang S, Hu XY. A survey and analysis on current status of the need and service for geriatric nursing in Sichuan Province[J]. Chin J Nurs, 2023, 58(19):2339-2344. DOI
[17]	Takahashi M. Insurance coverage,long-term care utilization,and health outcomes[J]. Eur J Health Econ, 2023, 24(8):1383-1397. DOI
[18]	Zhou YR, Zhang X. The experience and enlightenment of the community-based long-term care in Japan[J]. Healthcare, 2022, 10(9):1599. DOI URL
[19]	代莉莉, 段艳芹, 张梅, 等. 社区老年人居家护理服务需求结构性研究[J]. 中国全科医学, 2021, 24(25):3238-3243. DOI
	Dai LL, Duan YQ, Zhang M, et al. Demand for home care services in the elderly in the community:a structural study[J]. Chin Gen Pract, 2021, 24(25):3238-3243.
[20]	王春芳, 周雨欣, 封海霞, 等. 徐州市养老机构护理服务发展现状及老年人服务需求调查[J]. 护理研究, 2022, 36(16):2973-2977.
	Wang CF, Zhou YX, Feng HX, et al. Development status quo of nursing service in nursing homes of Xuzhou city and the service demand of the elderly[J]. Chin Nurs Res, 2022, 36(16):2973-2977.
[21]	李秀秀, 崔欣, 王欣宁, 等. 上海市某区失能老年人长期护理保险服务项目供需匹配现状分析[J]. 医学与社会, 2025, 38(9):106-114.
	Li XX, Cui X, Wang XN, et al. Analysis on status quo of the matching between supply and demand of the long-term care insurance service project for the disabled elderly in a certain district of Shanghai[J]. Med Soc, 2025, 38(9):106-114.
[22]	王春子, 万铃珊, 薛佳, 等. 基于长期护理保险需求的老年人机构照护意愿及其影响因素研究[J]. 健康发展与政策研究, 2025, 28(2):155-162. DOI
	Wang CZ, Wan LS, Xue J, et al. The willingness of elderly people to receive institutional care based on long-term care insurance demand and its influencing factors[J]. Health Dev Policy Res, 2025, 28(2):155-162.
[23]	覃朝晖, 刘莎, 卢亚娟, 等. 江苏省城镇老年人长期护理保险需求状况及其影响因素[J]. 医学与社会, 2022, 35(1):78-83.
	Qin ZH, Liu S, Lu YJ, et al Demand status of long-term care insurance for the urban older adults in Jiangsu Province and its influencing factors[J]. Med Soc, 2022, 35(1):78-83.