丧子对中老年人健康及卫生服务利用影响研究  

The impact of parental bereavement on the health and healthcare utilization of middle-aged and elderly people

作　　者：谈慧敏 孙峥岫 汪航 马超[1] TAN Huimin;SUN Zhengxiu;WANG Hang;MA Chao(School of Public Health,Southeast University,Nanjing,Jiangsu 210009,China;不详)

机构地区：[1]东南大学公共卫生学院,江苏南京210009 [2]东南大学经济管理学院 [3]中国医学科学院北京协和医学院北京协和医院

出　　处：《中国预防医学杂志》2025年第1期27-31,共5页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(72074045)。

摘　　要：目的探究丧子经历对我国中老年人身心健康及卫生服务利用的影响,为提升中老年人健康服务提供依据。方法使用中国健康与养老追踪调查(China Healthand Retirement Longitudinal Study,CHARLS)2013年、2015年和2018年三期面板数据,采用双重差分(difference-in-differences,DID)法识别策略评估丧子对我国中老年人自评健康、失能、慢性病、抑郁症状以及月门诊次数、月门诊费用、年住院次数和年住院费用的影响。结果丧子经历导致中老年人自评健康得分下降0.17分,工具性日常活动自理能力(instrumental activities of daily living,IADL)障碍数目增加了0.33个,慢性病数量增加0.26种,抑郁量表(center for epidemiologic studies depression,CESD)得分增加2.01分;卫生服务利用方面,丧子经历使中老年人过去1年住院花费提升,差异有统计学意义(β=0.45,P<0.05),但过去1个月门诊就诊次数(β=-0.21,P=0.288)及其费用(β=-0.01,P=0.983)和住院次数(β=0.06,P=0.277)变化差异无统计学意义。结论丧子在损害中老年人身心健康的同时有可能引发“消极就医”;政府部门应建立专门的养老照护机构,加大财政倾斜力度,防止该弱势群体陷入健康贫困陷阱。Objective This study explores the impact of parental bereavement experience on the health and healthcare utilization of middle-aged and elderly people in China,to provide basis for improving health services of the middle-aged and elderly people.Methods Using the China Health and Retirement Longitudinal Study(CHARLS)panel data from 2013,2015,and 2018,under the difference-in-differences(DID)identification strategy,the study evaluated the impact of parental bereavement on self-rated health,disability,chronic diseases,depressive symptom,monthly outpatient visits,monthly outpatient expenses,annual hospitalization visits,and annual hospitalization expenses among middle-aged and elderly people in China.Results The results showed that bereavement experience led to a decrease of 0.17 points in self-rated health scores,an increase of 0.33 in the number of instrumental activities of daily living(IADL)disabilities,an increase of 0.26 in the number of chronic diseases,and an increase of 2.01 in the center for epidemiologic studies depression(CESD)scale score.In terms of healthcare utilization,the experience of bereavement significantly increased the cost of hospitalization last year for middle-aged and older people(β=0.45,P<0.05),but neither the number of outpatient visits(β=-0.21,P=0.288),nor their cost(β=-0.01,P=0.983)last month,nor the number of hospitalizations(β=0.06,P=0.277)last year did not change significantly.Conclusions The experience of child loss may lead to a"passive medical seeking attitude"while damaging the physical and mental health of middle-aged and elderly people.Government departments should establish specialized elderly care institutions,increase financial support,and prevent this vulnerable group from falling into a health poverty trap.

关 键 词：丧子 中老年人 卫生服务利用 双重差分 

分 类 号：R195[医药卫生—卫生统计学] C913.6[医药卫生—卫生事业管理]