摘要
目的:探讨社会医疗保险和健康传播对老年流动人口的健康效应及其作用机制,为促进流动老年人口健康以及推动积极老龄化战略实施提供参考。方法:数据来源为2017年全国流动人口动态监测调查数据,以6478名流动老人作为研究对象,进行有序多分类logistic回归分析和多重线性回归分析。结果:社会医疗保险通过医疗服务利用机制(β=0.144,Ρ<0.05)影响流动老人健康,城乡居民基本医疗保险(β=-0.336,Ρ<0.05)和城镇职工基本医疗保险(β=-0.316,Ρ<0.05)对流动老人生理健康有显著负向影响。健康传播通过医疗服务可及性(β=0.064,Ρ<0.05)、医疗服务利用(β=0.283,Ρ<0.001)以及健康素养机制(β=0.565,Ρ<0.001)对流动老人健康有显著促进作用。结论:社会医疗保险对老年流动人口没有明显健康效应,参与健康传播有利于提升老年流动人口的健康水平。建议推动健康资本投资从经济导向到素质导向的转型升级,以社区为单位构建专业保健人员、基层服务者以及流动老人共同参与的健康传播网络。
Objective:To explore the health effects of social medical insurance and health communication on the elderly floating population and their mechanisms of action, so as to provide references for promoting the health of floating elderly and promoting the implementation of active aging strategy. Methods:This paper took 6478 floating elderly as research objects in the China migrants dynamics survey in 2017, and ordinal logistic regression analysis and multiple linear regression analysis were used in this study. Results:Social medical insurance affected the health of floating elderly through the mechanism of medical service utilization(β=0.144,Ρ<0.05),and basic medical insurance scheme for urban and rural residents(β=-0.336,Ρ<0.05)and basic medical insurance scheme for employees(β=-0.316,Ρ<0.05)had significant negative effects on the physical health of floating elderly. Health communication played a significant role in promoting the health of floating elderly through the mechanism of medical service accessibility(β=0.064,Ρ<0.05), medical service utilization(β=0.283,Ρ<0.001)and health literacy(β=0.565,Ρ<0.001). Conclusion:Social medical insurance has no significant health effects on elderly floating population, and participation in health communication is conducive to improving the health level of elderly floating population. It is suggested to promote the transformation and upgrading of health capital investment from economic orientation to quality orientation and build a health communication network with the participation of professional health care personnel, grassroots service providers and floating elderly in the community.
作者
马婕菲
蔡弘
丁仁船
MA Jiefei(Center for Urban Management Research,Anhui Jianzhu University,Hefei,Anhui,230601,China)
出处
《医学与社会》
北大核心
2023年第3期60-65,共6页
Medicine and Society
基金
国家社会科学基金资助项目,编号为18BRK016
安徽省哲学社会学科规划青年项目,编号为AHSKQ2020D123
安徽省教育厅创新协同项目子课题,编号为GXXT-2021-044,子课题号为2022SZWT001。
关键词
社会医疗保险
健康传播
流动人口
老年人
健康效应
Social Medical Insurance
Health Communication
Floating Population
Older Adult
Health Effect
