目的 分析社会经济地位对流动老年人卫生服务利用的影响,为进一步提高流动老年人医疗服务利用水平提供实证依据.方法 以中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2018为资料来源,以安德森医疗服务利用模型为基本解释框架,采用两部模型法分析社会经济地位对流动老年人卫生服务利用的影响.结果 模型1、模型2结果显示,与未受过教育和低收入者相比,受过教育和高收入的流动老年人患病后就诊概率分别高8.60％、2.50％.模型3、模型4结果显示,与未受过教育和低收入者相比,受过教育和高收入的流动老年人就诊支出分别高26.70％、0.80％.需求因素(自评健康、患慢性病情况)和使能资源(参与社会活动、参加医疗保险)对流动老年人"患病后是否就诊"、就诊后"医疗支出"具有显著正向影响.模型5中,自理能力在影响流动老年人患病后是否就诊中具有正向调节效应.结论 社会经济地位、需求因素和使能资源对流动老年人卫生服务利用具有增益性.自理能力在社会经济地位影响流动老年人卫生服务利用中具有调节作用.应降低社会经济地位导致的就医不平等,完善医疗保险的保护作用.
Effect of of socioeconomic status on health service utilization among migrant elderly
Objective This study aims to analyze the impact of socioeconomic status on health service utilization among migrant elderly people,and provide an empirical basis for further improving the utilization level of health services among this population.Methods Using the 2018 China Health and Retirement Longitudinal Study(CHARLS)as the data source and the Anderson medical service utilization model as the basic interpretation framework,a two-part model method was used to analyze the impact of socioeconomic status on health service utilization among mobile elderly people.Results The results of Model 1 and Model 2 show that compared with uneducated and low-income individuals,educated and high-income mobile elderly individuals have an 8.60％and 2.50％higher probability of seeking medical treatment after illness,respectively.The results of Model 3 and Model 4 indicate that compared with uneducated and low-income individuals,the medical expenses of educated and high-income mobile elderly people are 26.70％and 0.80％higher,respectively.Demand factors(self-evaluation of health,chronic disease status)and enabling resources(participation in social activities,participation in medical insurance)have a significant positive impact on the"whether to seek medical treatment after illness"and"medical expenses"of mobile elderly people.In Model 5,the self-care ability has a positive moderating effect on whether mobile elderly people seek medical treatment after illness.Conclusions Socioeconomic status,demand factors,and enabling resources have a positive effect on the health service utilization of mobile elderly individuals.Self-care ability plays a regulatory role in the influence of socioeconomic status on health service utilization among this population.Therefore,measures should be taken to improve the economic security of the migrant elderly,reduce the inequality of medical treatment caused by socioeconomic status,improve the protective role of health insurance.
Socioeconomic statusMedical behaviorHealth service utilizationMigrant elderly
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NSTL
万方数据
