摘要
目的:探究我国老年人医疗与健康照料服务可及性的变动轨迹及其影响因素,为优化健康老龄化服务体系提供参考.方法:基于 2005-2018 年中国老年健康影响因素跟踪调查数据,选择其中 2660 位 65岁以上的老年人,运用潜在类别增长模型识别出我国老年人医疗与健康照料服务可及性的变动轨迹类型,并分析变动轨迹类型的影响因素及其性别差异.结果:识别出我国老年人存在3 类医疗与健康照料服务可及性变动轨迹,分别为高起点稳定型(n=2230,84.1%),中起点变动上升型(n=222,8.1%)和高起点逐渐下降型(n=208,7.8%).年龄、性别、婚姻状态、社会保障、健康自评情况等因素对老年人医疗与健康照料服务可及性的变动轨迹产生影响(P<0.05).婚姻状态、居住地、所在地区、工作状况、子女经济支持等因素对男性和女性老年人医疗与健康照料服务可及性变动轨迹的影响存在差异(P<0.05).结论:我国老年人医疗与健康照料服务可及性的变动轨迹存在异质性,而影响其医疗与健康照料服务可及性变动轨迹类型形成的因素也存在性别差异.社会保障、家庭支持等社会经济因素以及身体状态等社会人口因素影响医疗与健康照料服务可及性的变动轨迹.有必要发挥好家庭支持与社会保障的互补效应,促进老年人医疗及照料资源配置的公平性和有效性.
Abstract
Objective:To explore the trajectory of accessibility to medical and health care services and its influencing factors among older adults in China and to provide a reference for optimizing the service system for healthy aging.Methods:Based on the 2005-2018 follow-up survey data of health and longevity of the elderly in China,2660 people over 65 years old were selected,this paper identified the trajectories of medical and health care accessibility for older adults in China by using the latent category growth model,and analyzed the influencing factors and gender differences.Results:Three types of trajectories of accessibility to medical and health care services were identified,including persistent(n=2230,84.1%),increasing(n=222,8.1%),and decreasing(n=208,7.8%)types.The influencing factors of trajectories of accessibility were age,gender,marital status,social security,self-rated health and so on(P<0.05).Marital status,residence,region,employment status,children's financial support and so on had gender-specific impacts on the trajectory of accessibility(P<0.05).Conclusion:There is heterogeneity in the trajectory of medical and health care service accessibility for older adults in China and its influencing factors have gender difference.Socio-economic factors such as social security and family support,as well as socio-demographic factors such as physical status,shape the trajectory of accessibility to medical and health care services.Therefore,family support and social security should complement each other to promote the equity and validity of medical and care resource delivery for older adults.
NETL
NSTL
万方数据