Health Care Facilities for Senior Citizens in Selected Tertiary Hospitals During Covid-19 Pandemic

Sathik Ali, M. Alam
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Abstract

Background: To assess the health care facilities provided for senior citizens in selected tertiary hospitals. Methods: This descriptive type of cross-sectional study was carried out among service providers (doctors and nurses) and hospital administrators within the period of January to December 2020. A total of 305 respondents was selected purposively. Semi structured questionnaire and observational checklist was used to collect data. Data was collected by face to face interview and observation. Data was analyzed by using SPSS (Statistical Package for Social Science) software version 25. Results: Among participants, Administrator 2.6%, Doctor 25.2% and Nurse 72.1%. Mean age of the respondents was 32.72±7.67 years. Most of the respondents 90.8% working experience less than 10 years and their average monthly income was Tk. 35398.90±16509.12. In DMCH separate geriatric ward present but in BSMMU geriatric ward absent. Rehabilitation center & long-term care facilities for elderly patients, telemedicine service, separation facility for non COVID geriatric patients from COVID positive patients, free care facility for poor elderly patients, social welfare support facilities present in both hospitals. Separate bed facility in general wards, geriatric ICU and COVID ward absent, training facility on geriatric health absent in both hospitals. Majority of the respondents 97.0% take consent before any procedure, 89.6% service provider involve geriatric patients in decision making about their care and treatment, 56.6% respondents follow polypharmacy guideline. Opinion regarding utility service was average. Opinion regarding diagnostic facilities, essential drugs, sterilization facilities, of this hospital for senior citizens was moderately sufficient 50.5%, 60.6% and 59.3% respectively and ambulance service insufficient 53.4%. Among respondents 89.8% face barriers in providing geriatric health care. Opinion regarding the existing health care facilities for senior citizens of this hospitals insufficient 52.8%. Regarding improvement of health care services 26.0% mentioned that training of doctor/ nurses followed by separate geriatric ward facilities for geriatric patients 20.8%, increase the number of supporting staff 16.2%, free health care facilities for poor elderly patients 11.8%, training of supporting staffs 10.6%, training for informal/family caregiver 7.4%, separate bed for geriatric patient in general wards 6.4% and the rest others mentioned 0.7%. Analysis found statistically significant association between national guideline follow for the treatment and care of older patients and their educational qualification (0.001), designation (p=0.001), polypharmacy guideline follows for the treatment and care of older patients and their designation, referral guideline follows for geriatric patients and their designation (p=0.001). Conclusion: To provide quality healthcare service to the senior citizens of Bangladesh, geriatric health care should be given highest priority. JOPSOM 2021; 40(1): 51-58
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2019冠状病毒病大流行期间选定三级医院老年人卫生保健设施
背景:评价选定的三级医院为老年人提供的卫生保健设施。方法:在2020年1月至12月期间,对服务提供者(医生和护士)和医院管理人员进行描述性横断面研究。有目的地选择了305名受访者。采用半结构化问卷和观察性检查表收集资料。采用面对面访谈和观察的方式收集资料。数据分析采用SPSS (Statistical Package for Social Science)软件25版。结果:参与者中,管理员占2.6%,医生占25.2%,护士占72.1%。平均年龄32.72±7.67岁。90.8%的受访者工作经验不足10年,平均月收入为35398.90±16509.12塔卡。在DMCH有单独的老年病房,但在BSMMU没有老年病房。老年患者康复中心和长期护理设施、远程医疗服务、非新冠老年患者与新冠阳性患者分离设施、贫困老年患者免费护理设施、两家医院均设有社会福利支持设施。普通病房、老年重症监护病房和新冠肺炎病房没有单独的床位设施,两家医院都没有老年健康培训设施。97.0%的受访者在任何手术前都征求同意,89.6%的服务提供者参与老年患者的护理和治疗决策,56.6%的受访者遵循综合用药指南。对公用事业服务的意见一般。对老年人医院诊断设施、基本药品、消毒设施的意见分别为50.5%、60.6%和59.3%,救护车服务不足的意见为53.4%。在答复者中,89.8%的人在提供老年保健方面面临障碍。52.8%的人认为该医院现有的老年人保健设施不足。关于改善保健服务,26.0%的人提到培训医生/护士,其次是为老年患者提供单独的老年病房设施20.8%,增加辅助人员人数16.2%,为贫困老年患者提供免费保健设施11.8%,培训辅助人员10.6%,培训非正式/家庭护理人员7.4%,为普通病房的老年患者提供单独床位6.4%,其他提到0.7%。分析发现,老年患者治疗和护理的国家指南遵循与他们的教育程度(0.001)、名称(p=0.001)、老年患者治疗和护理的综合用药指南遵循及其名称、老年患者转诊指南遵循及其名称(p=0.001)之间存在统计学显著相关。结论:要为孟加拉国的老年人提供优质的医疗保健服务,应优先考虑老年保健。JOPSOM 2021;(1): 40 51-58
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