摘要
医养结合是实现健康中国和积极老龄化战略的重要手段,也是养老服务体系高质量发展的必要条件。文章利用微观数据,运用双重差分法实证检验了医养结合政策试点对老年健康管理服务利用的影响。研究发现,医养结合政策试点显著促进了老年健康体检服务、健康评估和干预服务的利用以及健康档案的建立,提升了老年健康管理服务利用水平,但这种影响因城市地理区位、行政等级及老龄化水平的不同而呈现差异化的效果。进一步分析表明,医养结合政策试点通过政策集聚效应、增加政府资金投入、推动设施临近设置和拓展服务方式等机制对老年人相关健康管理服务的利用产生显著影响。文章研究认为,我国目前医养结合发展正处于由国家试点向示范项目引领和全国推广的关键阶段,应充分发挥医养结合政策试点的政策效应与示范项目的引领作用;加强医养结合政策对不同经济发展水平、不同行政等级或不同老龄化水平城市的适配性,避免政策的“一刀切”;要重视社区医养结合设施的建设和功能布局;优化服务方式,化被动为主动,积极提升健康管理的有效性。
The integration of medical and elderly care is an important means to realize the strategy ofhealthy China and active aging,and it is also a necessary condition for the high-quality development of the social elderly care service system.Based on the data of CHARLS,this paper systematically evaluates the impactof the pilot of integrated medical and elderly care policy on the utilization of elderly health management services by using a DID model.It is found that this policy significantly promotes the utilization of elderly healthexamination services,health assessment and intervention services,and the establishment of health records,andimproves the utilization level of elderly health management services,but this impact shows different effectsdepending on the geographical location,administrative level,and aging level of the city.Further analysisshows that this policy has a significant impact on the utilization of health management services for the elderlythrough mechanisms such as policy agglomeration effect,increased government capital investment,promotionof facility proximity,and expansion of service methods.The study believes that the development of integratedmedical and elderly care in China is currently in a critical stage of leading from national pilot projects todemonstration projects and promoting them nationwide.The policy effect of pilot projects and the leading roleof demonstration projects should be fully exerted.The adaptability of integrated medical and elderly carepolicy to cities with different economic development levels,administrative levels,or aging levels should bestrengthened to avoid the“one-size-fits-all”policy;the construction and functional layout of community medical and elderly facilities should be attached importance to;and service methods should be optimized to turnpassivity into proactivity and actively improve the effectiveness of health management.The marginal contributions of this paper are as follows:First,it sorts out in detail the connotation of elderly health management from the
作者
陈岩
杨翠迎
Chen Yan;Yang Cuiying(School of Public Economics and Management,Shanghai University of Finance and Economics,Shanghai 200433,China)
出处
《财经研究》
北大核心
2023年第12期121-135,共15页
Journal of Finance and Economics
基金
国家社会科学基金重大项目(20&ZD114)
中央高校基本科研业务费专项资金资助(CXJJ-2023-355)。
关键词
医养结合试点
老年健康管理
服务利用
人口老龄化
pilot of integrated medical and elderly care
elderly health management
serviceutilization
population aging
