中老年人门诊和住院服务利用影响因素的比较研究
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福建医科大学公共卫生学院

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R161.7

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福建省高校杰出青年科研人才培育计划项目(2018B030)


Comparative study on the influencing factors of outpatient and inpatient service utilization of middle-aged and elderly people
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School of Public Health, Fujian Medical University

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    摘要:

    基于中国健康与养老追踪调查(CHARLS)2015年数据,确定我国中老年人门诊和住院服务利用情况,并进一步采用卡方检验和logistic回归分析,探究其影响因素及差异。研究结果显示:中老年人四周患病率为29.5%,四周就诊率为20.2%,中老年患者四周未就诊比例为31.4%;中老年人年住院率为14.0%,中老年患者年应住院未住院比例为29.9%。不同慢性病患病情况、医疗保险类型、经济水平、自评健康状况和过去两年是否体检是中老年人门诊和住院服务利用的共同影响因素,性别和年龄是门诊和住院服务利用的相异影响因素。建议政府、社会和个人共同发力,形成有效的慢性病防治体系。完善分级诊疗制度,提高卫生服务可及性;在提高居民可支配收入的同时,提升医疗保险补偿水平,减轻中老年人医疗负担。此外,还应强化中老年人健康教育,增强其健康意识。

    Abstract:

    Objective: To understand the utilization of health services for middle-aged and elderly people in China, and compare the different factors affecting the utilization of outpatient and inpatient services. Methods: Based on the 2015 "China Health and Retirement Longitudinal Study" (CHARLS) data, a total of 12 974 participants were included. Thechi-square test was used for univariate analysis, and the logistic regression model was used for multivariate analysis. Results: The four-week prevalence rate of middle-aged and elderly people was 29.5%, the four-week consultation rate of middle-aged and elderly people was 20.2%, and 31.4% middle-aged and elderly patients did not visit hospital; The annual hospitalization rate of middle-aged and elderly people was 14.0%, and the annual hospitalization rate of middle-aged and elderly patients was 29.9%. The common influencing factors for the use of outpatient and inpatient services for middle-aged and elderly people included the prevalence of different chronic diseases, type of medical insurance, economic level, self-assessment of health status, whether having physical examination in the past two years. Gender had a significant impact on the use of outpatient services, but not to the use of inpatient services; Age had a significant impact on the use of inpatient services, but not to the use of outpatient services. Conclusion: Health status, economic level, medical insurance type and health awareness were the common influencing factors for the use of outpatient and inpatient services in middle-aged and elderly people, and gender and age were the influencing factors for the different utilization of outpatient and inpatient services. It was recommended to further increase the compensation level of the medical insurance system and reduce the disease burden. In addition, health education for middle-aged and elderly people should be strengthened to enhance their health awareness.

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  • 收稿日期:2020-09-01
  • 最后修改日期:2020-11-05
  • 录用日期:2021-04-20
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