老年人社区满意度对基层卫生服务利用的影响及边际效应研究  

The impact and marginal effects of community satisfaction on utilization of primary health services among the elderly

作　　者：王鑫[1] 和红[1,2] WANG Xin;HE Hong(School of Population and Health,Renmin University of China,Beijing 100872,China;Institute of Health Science,Renmin University of China,Beijing 100872,China)

机构地区：[1]中国人民大学人口与健康学院,北京100872 [2]中国人民大学健康科学研究所,北京100872

出　　处：《中国卫生政策研究》2024年第8期10-18,共9页Chinese Journal of Health Policy

基　　金：中国人民大学科学研究基金(中央高校基本科研业务费专项资金资助)项目(23XNL013)。

摘　　要：目的:分析中国老年人基层卫生服务需求和利用率,探讨社区满意度对老年人基层卫生服务利用的影响及边际效应。方法:基于2018年中国老年社会追踪调查数据,选取6889名60岁及以上老年人纳入本研究。运用Logistic模型探究老年人社区满意度对其基层卫生服务利用的影响,并进行边际效应分析。结果:老年人社区满意度与基层卫生服务利用正相关,平均边际效应为4.6%,均值边际效应为1.4%。更换回归模型后结果保持稳健。社区满意度对高需求老年人基层卫生服务高利用的边际效应为11.0%,强于低需求老年人(0.4%);对城区老年人基层卫生服务高利用的边际效应为1.6%,强于村镇老年人(1.1%)。结论和建议:高水平的社区满意度是促进老年人(尤其是高需求老年人)基层卫生服务利用的要素之一。社区满意度对老年人基层卫生服务利用的边际效应存在城乡差异,可能是由于城乡社区卫生资源配置的不平衡。建议社区工作者通过多种途径提升老年人的社区满意度,以助力基层卫生服务利用,同时政府应促进城乡基层卫生资源配置均衡,以避免城乡基层卫生服务利用不公平性。Objective:To analyze the demand and utilization of primary health services among the elderly in China,and to explore the impact and marginal effects of community satisfaction on the utilization of primary health services.Methods:Based on data from the 2018 China Longitudinal Aging Social Survey,6889 older adults aged 60 years and above were included in this study.Logistic models and marginal effects were used to explore the impact of community satisfaction of the elderly on their primary health service utilization.Results:Community satisfaction of the elderly was positively associated with the utilization of primary health services,with a average marginal effect of 4.6%and a marginal effect at the mean of 1.4%.The result remained robust after replacing the regression model.The marginal effect of community satisfaction on high-utilization of primary health services for high-need elderly was 11.0%,which was stronger for the elderly in low-need(0.4%).The marginal effect for the elderly living in urban areas was 1.6%,stronger than that for the elderly living in rural areas(1.1%).Conclusions and Suggestions:A high level of community satisfaction is one of the elements to promote the utilization of primary health services for the elderly,especially those with high-need.There is a urban-rural difference in the marginal effect of community satisfaction on the utilization of primary health services for the elderly,which may be due to the imbalance of the allocation of community health resources between urban and rural areas.It is recommended that community social workers can improve community satisfaction among the elderly through various ways to help the utilization of primary health services.At the same time,the government should promote a balanced allocation of primary health resources between urban and rural areas to avoid inequity in the use of primary health services between urban and rural areas.

关 键 词：老年人 基层卫生服务需求 基层卫生服务利用 社区满意度 

分 类 号：R197[医药卫生—卫生事业管理]