基于间接标化法的老年人卫生服务利用公平性研究  

Research on the Equity of Health Service Utilization of the Elderly Based on Indirect Standardization Method

作　　者：黄豆豆 郭斌[1] 程怀志 刘艳瑞[1] 王海臣[1] 张婷婷[1] 孔令杉 HUANG Doudou;GUO Bin;CHENG Huaizhi;LIU Yanrui;WANG Haichen;ZHANG Tingting;KONG Lingshan(Department of Humanites and Social Sciences,Daqing Campus of Harbin Medical University,Daqing 163319,China)

机构地区：[1]哈尔滨医科大学大庆校区人文社会科学系,黑龙江大庆163319

出　　处：《中国医学伦理学》2020年第3期363-367,共5页Chinese Medical Ethics

基　　金：国家自然科学基金青年项目“健康老龄化视角下老年人医疗服务需求与医疗保障制度优化策略研究”(71704039);黑龙江省省属高等学校基本科研业务费基础研究项目“基于城乡差异的视角研究人口老龄化对卫生服务的影响”(2017RWZX16);黑龙江省卫生计生委课题“黑龙江省老年人卫生服务利用现状及公平性研究”(2017-171)。

摘　　要：利用第五次国家卫生服务调查(黑龙江省)老年人数据,通过非线性回归模型的间接标化法测算老年人实际利用、需要预期利用、需要标化后利用和集中指数,比较不同经济收入的老年人群门诊和住院服务利用的公平性。结果发现黑龙江省老年人卫生服务利用存在不公平,门诊服务利用要好于住院服务利用。不同收入组的老年人卫生服务利用公平性差异较大,门诊服务利用最高收入组是最低收入组的1.30倍,住院服务利用最高收入组是最低收入组的3.01倍;老年人卫生服务利用不公平主要受社会经济因素的影响。建议完善老年人群医疗卫生服务体系,提高卫生服务质量及可及性;健全基本医疗保障制度,进一步提高保障水平;加大对低收入老年人群的医疗救助力度,促进老年人卫生服务利用公平性,提高老年人健康水平,实现健康老龄化。Using the data of the fifth national health service survey in Heilongjiang province on the elderly,the indirect standardization method of the nonlinear regression model was used to calculate the actual utilization,expected utilization,post standardized utilization and concentration index of the elderly,and to compare the fairness of outpatient and inpatient service utilization of the elderly with different economic incomes.The results showed that the utilization of health services for the elderly in Heilongjiang province was unfair,and the fairness of outpatient service utilization was better than that of inpatient service utilization.The fairness of health service utilization among the elderly in different income groups was significantly different,with the richest group using outpatient services1.30times as much as the poorest group,and the richest group using inpatient services 3.01 times as much as the poorest group.The inequity of health service utilization of the elderly is mainly affected by social and economic factors.It is suggested to improve the medical and health service system for the elderly to improve the quality and accessibility of health services,improve the basic medical security system and further improve the level of security,increase the medical assistance for the low-income elderly,promote the fairness of the use of health services for the elderly,improve the health level of the elderly,and achieve healthy aging.

关 键 词：卫生服务利用 公平性 间接标化法 医疗保障制度 健康老龄化 

分 类 号：R-052[医药卫生]