The Effects of Community Medical Resources and Their utilization on the End-of-life Location of the Older People in China From an Inter-provincial Perspective:An Empirical Analysis of CLHLS Mortality Samples
The spatial and provincial differences in the development of medical services in China have created horizontal structural distribution of the old adults'end-of-life locations,which is different from the vertical distribution of that in the West.This study,based on the micro data from the mortality sample of CLHLS and the macro data from the provincial level of the China Statistical Yearbook,analyzes the effect of community medical resources and their utilization on the end-of-life locations of the elderly old and its changes in China from an inter-provincial spatial perspective.The findings show that the inter-provincial differences can explain about 13%of the end-of-life locations of the elderly in China,the effective supply and rational utilization of provincial-level community medical and health resources in the urban areas have significant promoting effect on the active home-return of the elderly for their end-of-life care,which is driven by the dual promotion of medical resource supply and its utilization,meanwhile the end-of-life at home of the older people in rural areas is mostly a passive choice due to the lack of medical resources and the full utilization of community medical and health resources can promote the active choose of the end-of-life care at home in the rural areas.In addition,the optimization of community medical resources and their utilization in the urban areas can reduce the income effect of the distribution of end-in-life places by increasing the probability of elderly from the high-income families to actively chose end-in-life care at home,and thereby increase the availability of the scarce hospital medical resources,as a comparison,the full utilization of community medical resources in rural areas can weaken the impact of disability on the end-of-life location of older people to reduce the passive home-based end-of-life care of disabled older people,and increase the possibility of disabled elderly people in rural areas to utilize the hospital medical resources.
End-of-life locationCommunity medical resourcesHierarchical logistic model
NETL
NSTL
万方数据
