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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    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χ2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4周患病率为29.5%,4周就诊率为20.2%,中老年患者4周应就诊而未就诊比例为31.4%;中老年人年住院率为14.0%,年应住院而未住院比例为28.8%。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:

    Based on the 2015 data from the China Health and Retirement Longitudinal Study (CHARLS), this study determined the utilization of outpatient and inpatient services among middle?aged and elderly people in China, and investigated and compared the differences in the influencing factors between them by the chi?square test and Logistic regression analysis. The results showed that the four?week morbidity rate among middle?aged and elderly people was 29.5%, the four?week outpatient visit rate was 20.2%, and the proportion of middle?aged and elderly patients who needed outpatient care in the last four weeks but did not visit the clinic was 31.4%. Besides, the one?year hospitalization rate of middle?aged and elderly people was 14.0%, and the proportion of middle?aged and elderly patients who needed inpatient care in the last year but did not get hospitalized was 28.8%. For the influencing factors of health services utilization of outpatient and inpatient services of middle?aged and elderly people, the same factors included the condition of chronic diseases, the type of medical insurance, economic level, self?reported health, and whether having physical examination in the past two years, gender and age are different influencing factors of outpatient and inpatient service utilization. It was strongly recommended to develop a prevention and treatment system for chronic disease by the concerted efforts among government, society and individuals. First, the hierarchical medical system should be improved to enhance the accessibility of health services. Second, while improving the income of residents, the coverage of medical insurance should be expanded to reduce the financial burden of the middle?aged and elderly. Third, health education for middle?aged and elderly people should be strengthened to enhance their health awareness.

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曾志超,邓清文,卢俊红,郑宇航,刘文彬.中老年人门诊和住院服务利用影响因素的比较研究[J].南京医科大学学报(社会科学版),2021,(2):165~170

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  • 收稿日期:2020-09-01
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  • 在线发布日期: 2021-04-30
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