社会隔离对老年人医疗服务利用的影响--基于中国家庭追踪调查数据的实证研究  

Effect of social isolation on medical service utilization of the elderly--Empirical study based on China family panel studies

作　　者：杨春晓 尹文强[1,3,4] 李秋莎 刘敏 许小凤 翟亚 李万鹏 黄冬梅 YANG Chun-xiao;YIN Wen-qiang;LI Qiu-sha;LIU Min;XU Xiao-feng;ZHAI Ya;LI Wan-peng;HUANG Dong-mei(School of Management,Weifang Medical University,Weifang,Shandong 261053,China;不详)

机构地区：[1]潍坊医学院管理学院,山东潍坊261053 [2]潍坊医学院公共卫生学院 [3]“健康山东”重大社会风险预测与治理协同创新中心,山东潍坊261053 [4]健康相关重大社会风险预警协同创新中心,上海200032

出　　处：《现代预防医学》2021年第24期4461-4466,共6页Modern Preventive Medicine

基　　金：国家自然科学基金(71573191)。

摘　　要：目的研究社会隔离对老年人医疗服务利用的影响,从社会隔离角度提出促进老年人医疗服务利用的对策建议。方法基于2018年中国家庭追踪调查(CFPS)数据,采用二元logit回归方法分析社会隔离对老年人医疗服务利用的影响,采用倾向值匹配法进行稳健性检验。结果本研究纳入研究的老年人共2794名,处于社会隔离状态的老年人占比为26.31%。未就诊的老年人中,处于社会隔离状态的占比86.90%;在未住院的老年人中,处于社会隔离状态的占比28.66%。社会隔离状态对老年人医疗服务利用具有负向影响(门诊、住院服务利用系数分别为-3.734、-0.343,P<0.05),经倾向值匹配检验证明该结论稳健(门诊服务利用1:4近邻匹配、卡尺匹配、核匹配ATT值分别为-0.416、-0.414、-0.414,住院服务利用对应ATT值分别为-0.053、-0.059、-0.059,P<0.05)。结论老年人社会隔离发生率较高,子女、社区首要担责预防老年人社会隔离,较高比例老年人面临社会隔离和医疗服务利用不足的“两难”处境,需要社区、家医、社工三方协作提供专业帮助。Objective To study the impact of social isolation on the utilization of medical services for the elderly, and to put forward countermeasures and suggestions to promote the utilization of medical services for the elderly from the perspective of social isolation. Methods Based on the data of China Family Panel Studies(CFPS) in 2018, binary logit regression method was used to analyze the impact of social isolation on health service utilization of the elderly, and propensity score matching method was used to test the robustness. Results A total of 2 794 elderly people were included in this study, and the proportion of elderly people in social isolation was 26.31%. Among the elderly who did not see a doctor, 86.90% were in social isolation. Among the elderly who were not hospitalized, 28.66% were in social isolation. The results of regression analysis showed that social isolation had a significant negative impact on the utilization of medical services for the elderly.The coefficients of outpatient and inpatient services were -3.734 and-0.343(P<0.05), respectively. The test of propensity score matching showed that the finding was robust. The Average Treatment Effect on the Treated(ATT) values of outpatient service utilization of 1:4 nearest neighbor matching, caliper matching and kernel matching were-0.416,-0.414, and-0.414,respectively, and the ATT values of inpatient service utilization were-0.053,-0.059, and-0.059, respectively(P <0.05).Conclusion The incidence of social isolation among the elderly is high, and children and the community have the primary responsibility to prevent social isolation among the elderly. A high proportion of the elderly face the “dilemma” of social isolation and underutilization of medical services, which requires the tripartite collaboration of community, family doctors and social workers to provide professional help.

关 键 词：老年人 社会隔离 医疗服务利用 倾向值匹配 

分 类 号：R197.1[医药卫生—卫生事业管理]