隔代照料孙辈对老年人医疗服务利用的影响研究  

A study on the impact of intergenerational caregiving on the utilization of healthcare services for the elderly

作　　者：雒敏[1,2] LUO Min(School of Public Health Policy and Management,Nanjing Medical University,Nanjing 211166,Jiangsu,China;Jiangsu Provincial Health Research Institute,Nanjing 211166,Jiangsu,China)

机构地区：[1]南京医科大学医政学院,江苏南京211166 [2]江苏省健康研究院,江苏南京211166

出　　处：《健康发展与政策研究》2024年第1期45-51,65,共8页HEALTH DEVELOPMENT AND POLICY RESEARCH

基　　金：教育部人文社会科学研究规划项目(22YJAZH078);江苏省社会科学基金项目(23SHB013)。

摘　　要：目的探讨隔代照料孙辈对老年人医疗服务利用水平的影响,并分析这种影响在不同的老年人群体中是否存在异质性。方法利用中国健康与养老追踪调查数据库中2018年全国追踪调查数据,筛选出4069名老年人的样本,采用处理效应模型和IV-Probit模型实证研究隔代照料孙辈与老年人医疗服务利用的关系。结果老年人照料孙子女的行为具有自选择性,隔代照料显著降低了老年人门诊(Z=−1.85,P<0.1)和体格检查(以下简称“体检”)服务利用水平(Z=−3.67,P<0.01),对住院服务利用的影响无统计学意义。提供隔代照料使老年人体检和门诊服务利用水平分别降低35.2%和16.5%,每周照料时间增加1.0%,老年人体检和门诊服务利用水平会相应下降4.4%和3.6%。亚组分析显示隔代照料对低龄老年人和农村老年人医疗服务利用的影响大于高龄老年人和城市老年人,对老年人的体检和门诊服务利用的影响不存在显著的性别差异,但对住院服务利用的影响存在性别差异。结论隔代照料降低了老年人医疗服务利用水平,需从多方面优化隔代照料支持政策,增强医疗服务供给能力,提高老年人健康福利水平。Objective To explore the impact of intergenerational caregiving on the utilization level of healthcare services for the elderly,and to analyze whether the impact is heterogenous among different groups of elderly people.Method Screened from the 2018 national tracking survey data from the China Health and Retirement Tracking Survey database,a sample of 4069 elderly people was selected to empirically investigate the relationship between intergenerational caregiving and the utilization of healthcare services in the elderly using the treatment effects model and the Instrumental Variables(IV)Probit model.Result The behavior of elderly people taking care of their grandchildren was self-selective,and intergenerational caregiving significantly reduced the utilization level of outpatient services(Z=−1.85,P<0.1)and physical examination services(Z=−3.67,P<0.01),with no statistically significant impact on the utilization of inpatient services.Intergenerational caregiving reduced the utilization level of physical examinations and outpatient services for the elderly by 35.2%and 16.5%,respectively.Again,a 1.0%increase in weekly caregiving hours would result in a corresponding 4.4% and 3.6% decrease in the utilization level of physical examinations and outpatient services for the elderly.Subgroup analysis showed a greater impact of intergenerational caregiving on the utilization of medical services for younger and rural elderly than for older and urban elderly.There are no significant gender differences in the utilization of physical examinations and outpatient services for the elderly.However,gender differences exist in the impact on the utilization of inpatient services.Conclusion Intergenerational caregiving has reduced the utilization level of healthcare services for the elderly,and there is a need to optimize the supportive policy for intergenerational caring from multiple aspects,to enhance the supply capacity of healthcare services,and to improve the health and welfare of the elderly.

关 键 词：隔代照料 老年人 医疗服务利用 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]