摘要
目的:基于健康状况的中介作用,分析经济支持、健康状况对我国老年人医疗卫生服务利用的影响机制。方法:将社会支持理论和安德森模型相结合,构建经济支持、健康状况对我国老年人医疗卫生服务利用影响机制的分析框架,并形成研究假设;利用2021中国综合社会调查数据与结构方程模型,对假设进行验证。结果:(1)家庭经济支持对我国老年人健康状况、医疗卫生服务利用均具有显著直接正向影响(P均<0.001);(2)家庭经济支持对我国老年人医疗卫生服务利用的影响效应,受老年人健康状况的“遮掩”,直接效应为0.140(P<0.001),间接效应为-0.152(P<0.001),总效应为-0.012,总效应不显著;(3)社会经济支持对我国老年人健康状况和医疗卫生服务利用均无显著直接影响;(4)社会经济支持通过中介变量(家庭经济支持),对我国老年人健康状况产生间接影响(P<0.001);(5)健康状况对我国老年人医疗卫生服务利用具有显著负向影响(P<0.001)。结论:现阶段家庭经济支持对我国老年人医疗卫生服务需求释放、健康状况提升发挥着更加直接与重要的作用,而社会经济支持是家庭经济支持的有效补充。建议发挥政府主导作用,不断完善多层次、多来源的经济支持保障体系,推进居家社区医养结合服务体系建设,有效满足老年人医疗卫生服务需求,保障老年人群健康权益。
Objective To analyze the influence mechanism of economic support and health status on the utilization of medical and health services for the elderly in China based on the intermediary role of health status.Methods Combining social support theory with Anderson model,an analytical framework of the influence mechanism of economic support and health status on the utilization of medical and health services for the elderly in China was constructed to form a research hypothesis.The hypothesis was veri-fied by using the data of comprehensive social survey in China in 2021 and structural equation model.Results Family financial support has a significantly direct and positive impact on the health status of the elderly and the utilization of medical and health services in China(P<0.001).The influence of family economic support on the utilization of medical and health services for the elderly in China was"covered"by the health status of the elderly,the direct effect of which was 0.140(P<0.001),the indirect effect was-0.152(P<0.001),and the total effect was-0.041,which was not significant.Social and economic support has no significantly direct impact on the health status of the elderly and the utilization of medical and health services in China.Social and economic support indirectly affects the health status of the elderly in China through the intermediary variable(family economic support)(P<0.001).Health status has a significantly negative impact on the utilization of medical and health services for the elderly in China(P<0.001).Conclusion In this stage,family economic support plays a more direct and important role in releasing the demand for medical and health services and improving the health status of the elderly in China,and social economic support is an effective supplement to family economic support.It is suggested that the government should play a leading role,constantly improve the multilevel and multi-source economic support security system,promote the construction of the service system combining medical care and nur
作者
程亚林
代涛
郑英
李力
Cheng Yalin(Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,P.R.China)
出处
《中国卫生事业管理》
北大核心
2024年第4期405-409,414,共6页
Chinese Health Service Management
基金
国家卫生健康委委托课题“公立医院公益性研究”。
关键词
人口老龄化
经济支持
医疗卫生服务利用
population aging
financial support
utilization of medical and health services.
