甘肃省医疗服务可及性对老年人自评健康状况的影响  

The Impact of Medical Service Accessibility on Self-rated Health Status of the Elderly in Gansu Province

作　　者：王晶 孟红燕 刘家瑞 张菊霞 WANG Jing(School of Nursing,Gansu University of Chinese Medicine,Lanzhou,Gansu,730000,China)

机构地区：[1]甘肃中医药大学护理学院,甘肃兰州730000 [2]甘肃省人民医院临床教学部,甘肃兰州730000

出　　处：《医学与社会》2025年第4期52-59,共8页Medicine and Society

基　　金：国家自然科学基金资助项目,编号为7226400;甘肃省人民医院院内科研基金项目,编号为22GSSYD-54、22GSSYC-7;中国医药教育协会重大科学攻关项目,编号为2022KTZ010。

摘　　要：目的:探讨甘肃省医疗服务可及性对老年人自评健康状况的影响,为提升老年人健康状况提供针对性建议。方法:于2023年7-9月,采用多阶段分层整群随机抽样的方法,抽取甘肃省19040位老年人并进行问卷调查,构建多重线性回归和二分类logistic回归模型进行定量分析。结果:多重线性回归和二分类logistic回归分析结果均显示,步行前往最近医疗卫生机构的时间越短、获得交通工具越容易、诊疗费用下降、每年至少体检一次、有健康会诊服务以及生病后能及时就医的老年人自评健康状况较好(P<0.05)。结论:甘肃省医疗服务可及性显著影响老年人的自评健康状况。在地理方面,需要合理布局农村或偏远地区基层医疗站点的位置,切实推进家庭医生签约服务和“互联网+医疗健康”服务;在经济方面,医疗系统应提高老年人的医保报销比例并扩大报销范围;在资源保障方面,相关部门应定期开展免费体检、健康教育和健康会诊等活动。Objective:To explore the impact of medical service accessibility on the self-rated health status of the elderly in Gansu Province,and to provide targeted recommendations for improving the health of the elderly.Methods:A multi-stage stratified whole cluster random sampling method was used to select 19040 elderly people in Gansu Province and conduct questionnaire surveys from July to September 2023,and multiple linear regression and binary logistic regression models were constructed for quantitative analysis.Results:Both multiple linear regression and binary logistic regression analyses showed that older adults with shorter walking time to the nearest health care facility,easier access to transportation,decreased consultation costs,at least one medical checkup per year,availability of health consultation services,and timely access to health care when sick had better self-assessed health status(P<0.05).Conclusion:The accessibility of medical services in Gansu Province significantly affects the self-rated health status of older persons.In terms of geography,the location of primary health-care sites in rural or remote areas should be rationalized,and family doctor contracting services and"Internet+Healthcare"services should be effectively promoted;in terms of economics,the health-care system needs to increase the rate of reimbursement of health insurance for the elderly and expand the scope of reimbursement;and in terms of resource security,the relevant departments should regularly carry out activities such as free medical check-ups,health education and health consultations.

关 键 词：医疗服务可及性 老年人 自评健康状况 甘肃 

分 类 号：R-05[医药卫生] R197