中国老年人基层卫生服务需求和医疗卫生机构就诊现状及其影响因素分析  

Demand for primary health care service,medication seeking behaviors and their associates among elderly people in China

作　　者：和红[1,2,3] 闫辰聿 HE Hong;YAN Chen-yu(Institute of Health Science Research,School of Sociology and Population Studies,Renmin University of China,Beijing 100872,China)

机构地区：[1]中国人民大学人口与发展研究中心,北京100872 [2]中国人民大学健康科学研究所 [3]中国人民大学社会与人口学院

出　　处：《中国公共卫生》2022年第10期1241-1248,共8页Chinese Journal of Public Health

基　　金：北京市社科基金项目研究基地重点项目(17JDSRA004);中国人民大学公共健康与疾病预防控制交叉学科重大创新平台成果(2021PDPC)。

摘　　要：目的了解中国老年人基层卫生服务需求和医疗卫生机构就诊现状及其影响因素,为提高我国老年人基层医疗卫生服务利用提供参考依据。方法收集2018年中国老年社会追踪调查中9324名≥60岁老年人健康和相关服务板块数据分析我国老年人基层卫生服务需求和医疗卫生机构就诊情况,并应用多分类logistic回归模型和零膨胀负二项回归模型分析其影响因素。结果中国9324名≥60岁老年人中,有49.82%的老年人有基层医疗卫生服务需求,有41.95%的老年人选择生小病时去基层医疗卫生机构就诊。零膨胀负二项回归模型分析结果显示,非农业户口、领取养老金、日常活动能力较差和患慢性病的中国老年人基层医疗卫生服务需求较低,高中及以上文化程度、有社托养老意愿、养老意愿不确定、自评健康状况一般和健康的中国老年人基层医疗卫生服务需求较高;少数民族和领取养老金的中国老年人基层医疗卫生服务需求数目较少;非农业户口、高中及以上文化程度、有养老院养老意愿、养老意愿不确定、办理退休手续、日常活动能力较差、自评健康状况一般和健康的中国老年人基层医疗卫生服务需求数目较多。无序多分类logistic回归分析结果显示,未就诊与去基层医疗卫生机构就诊相比,年龄较大、少数民族和患慢性病的中国老年人更愿意选择去基层医疗卫生机构就诊,非农业户口、高中文化程度、日常活动能力较差、有社托养老和养老院养老意愿的中国老年人更愿意选择未就诊;到药店买药与去基层医疗卫生机构就诊相比,年龄较大、少数民族、个人年均收入较高、办理退休手续、日常活动能力较差、患慢性病和有基层医疗服务需求的中国老年人更愿意选择去基层医疗卫生机构就诊,非农业户口、初高中文化程度、自评健康状况一般和有社托养老意愿的中国老年人�Objective To explore the demand for primary health care service,behaviors of medication seeking at various medical institutions and their influencing factors among older people in China and to provide evidences for promoting the utilization of primary care services in the elderly.Methods Information on health status and utilization of medical service in9324 elderly people aged≥60 years were extracted from the 2018 dataset of China Longitudinal Aging Social Survey(CLASS)conducted across China since 2014.Multivariate logistic regression model and a zero-inflated negative binomial regression model were adopted in analysis on influencing factors of demand for primary health care service and medication behaviors of the elderly people.Results Of all the elderly,49.82%had a demand for primary health care services and41.95%had the willingness to seek medication at grassroots medical institutions when being with a minor illness.The results of the zero-inflated negative binomial regression model analysis showed that the demand for primary health care service was lower among the older people with non-agricultural household registration,old-age pension,poor activities of daily living,and chronic diseases but higher among those with the education of senior high school and above,the willingness to get social endowment,uncertain willingness for endowment pattern,general self-assessed health status,and a fair health condition;the number of required health care service items was larger among the older people with non-agricultural household registration,the education of junior high school and above,the willingness to get elderly care in nursing homes,uncertain willingness for endowment pattern,completed retirement procedures,poor activities of daily living,general self-assessed health status,and a fair health condition,while,the number was lower among the elderly people being ethnic minorities.The results of the unordered multivariate logistic regression analysis revealed that compared to the elderly people with the willingness

关 键 词：卫生服务需求 就诊 医疗卫生机构 基层 影响因素 老年人 中国 

分 类 号：C913.6[经济管理]