代际支持对老年人医疗服务利用的影响及异质性研究——基于倾向得分匹配的反事实估计  

Research on the Impact and Heterogeneity of Intergenerational Support on the Utilization of Medical Services for the Elderly--Counterfactual Estimation Based on Propensity Score Matching

作　　者：刘文军 Liu Wenjun(School of Public Administration,Zhongnan University of Economics and Law,Wuhan 430073,China)

机构地区：[1]中南财经政法大学公共管理学院,湖北武汉430073

出　　处：《中南财经政法大学研究生论丛》2023年第3期80-91,共12页Journal of the Postgraduates of Zhongnan University of Economics and Law

基　　金：中南财经政法大学中央高校基本科研业务费资助“代际支持缓解了老年人医疗服务利用不平等吗?”项目编号(202351224)。

摘　　要：本文运用Grossman健康需求理论和Andersen医疗服务利用模型,利用2018年中国老年健康影响因素跟踪调查数据,采用倾向得分匹配(PSM)方法,实证分析代际支持对老年人医疗服务利用的影响及异质性。研究发现:代际经济支持对老年人门诊和住院费用均存在显著的正向影响,其中代际经济支持对门诊费用的促进效应为20%-26.3%,对住院费用的促进效应为34.4%-45.6%,但代际情感支持和生活照料并不存在显著影响;组群差异显示,代际支持显著促进了农村和高龄老人对门诊医疗服务的利用,且代际生活照料对医疗服务利用的促进效应显著高于代际情感支持;此外,代际支持显著促进了城市老人对住院服务的需求且代际经济支持提高了老人住院服务的利用。基于以上结论,政府在制定健康老龄化战略中,需要重视非正式支持对医疗服务体系的影响,实施非正式支持政策有助于缓解老人“就医最后一公里”问题,从而提高老人的医疗服务可及性且释放医疗服务需求。This paper applies Grossmans s Health Demand Theory and Andersen s Medical Servia Utilization Model to empirically analyze the impact and heterogeneity of intergenerational support on elderly medical service utilization,using data from the 2018 China Elderly Health Impact Factor Tracking Survey and propensity score matching(PSM)method.The study has found that intergenerational financial support has a significant positive impact on both outpatient and inpatient expenses for the elderly,with a promotion effect of 20%-26.3%on outpatient expenses and 34.4%-45.6%on hospitalization expenses.However,intergenerational emotional support and daily care have no significant impact.Group differences show that the intergenerational support significantly promotes the utilization of outpatient medical services for rural and elderly people.Additionally,the promotion effect of intergenerational life care on medical service utilization is significantly higher than that of intergenerational emotional support.In addition,intergenerational support has significantly promoted the demand for hospitalization services for urban elderly people.Based on the above conclusions,governments need to pay attention to the impact of informal support on the medical service system when formulating strategies for healthy aging.Implementing informal support policies can help alleviate the“last mile”problem that elderly individuals face in seeking medical treatment,thereby improving their medical accessibility and releasing their demand for medical services.

关 键 词：代际支持 医疗服务利用 反事实估计 异质性 

分 类 号：R47[医药卫生—护理学]