Abstract: Background　In Huaibei region recently，the general population has demonstrated low rate of making appointments in contrast to high rate of contracting family doctor services，but the community-dwelling older people has showed high demand for home care services urgently. Studying the structural characteristics of the demand for medical services in elderly people is of great significance for precisely implementing interventions and maintaining public health. Objective　To analyze the structure of community-dwelling older people's demand for home care services，providing a basis for delivering home care services appropriately for such people. Methods　We conducted a survey using a self-developed questionnaire named Older People's Demand for Home Care Services among 2 137 elderly people selected from Huaibei region using cluster random sampling during October to December 2019. The Kano model was used to categorize and prioritize the demand. Results　A total of 1 924 valid questionnaires（90.03%） were collected. In all，there were 21 home care services belonging to five categories needed by these older people. Of the 15 with attractive attributes（physiological indices examination，regular physical examination，free expert consultation，home follow-ups，creating and maintaining health records，health consultation，preventive healthcare education，medication guidance，rehabilitation guidance，healthcare lectures，home-based medical care，emergency treatment，bed-ridden care，treatment-seeking assistance，and drug delivery），regular physical examination was needed most，and emergency treatment was relied on most heavily. Other six（hospice care，psychological counseling，rental services，remote medical care，medical insurance services，and healthcare policy publicity） have indifferent attributes. Conclusion　Our study indicates that community-dwelling older people in Huaibei region had seemingly low level of demand for medical care services，which may be caused by lack of knowledge and experience of home care services，and unexpressed potential needs. Clearly identifying the demand structure in older people living in different urban communities，and delivering targeted interventions will boost the implementation effectiveness of relevant healthcare policies，ensuring a good balance between supply and demand in healthcare.

Key words: Community health services, Aged, Kano model, Home care services, Structural research

摘要： 背景　近年来，淮北地区家庭医生签约服务的广覆盖和“签而不约”矛盾突出，与之相反的是老年人群对医疗卫生服务的迫切需求。研究老年人对医疗服务需求的结构特点，精准施策，对维护人民群众健康具有重要意义。目的　准确识别社区老年人居家护理服务需求结构层次，为精准提供老年人居家护理服务提供依据。方法　2019年10—12月，采用整群随机抽样法，使用自行设计的问卷对淮北地区2 139例老年人进行居家护理服务需求调查，应用Kano模型对调查项目要素进行需求层次和质量属性分类。结果　共回收有效问卷1924份（90.03%）。淮北地区老年人居家护理服务5大类21项需求项目中，15项（生理指标检测服务、定期体检服务、专家义诊服务、家庭访视服务、健康档案服务、健康咨询服务、预防知识服务、用药指导、康复指导、知识讲座、上门看病、突发疾病救治、卧床护理服务、协助就医、配送药服务）为魅力属性，其中，老年人对定期体检服务的期待性最高，对突发疾病救治服务的依赖性最高；6项（临终关怀服务、心理咨询服务、租赁服务、远程医疗服务、医疗保险服务、政策宣传服务）为无差异需求。结论　淮北地区老年人对护理服务需求整体偏低，对居家护理服务认知与体验不足，潜在需求未得到有效释放。应准确识别不同地区社区老年人的需求层次，精准施策，使国家相关政策效应得到最大释放，以保障护理服务需求与供给高效匹配。

关键词: 社区卫生服务, 老年人, Kano模型, 居家护理服务, 结构性研究