中老年慢病患者卫生服务利用及影响因素研究——基于CHARLS数据的实证分析  

Empirical Research on the Health Service Utilization in Middle-Aged and Elderly Patients with Chronic Diseases and Its Influencing Factors Based on Data of CHARLS

作　　者：周翔 段桂敏[1] 万圣洁 唐佳妮 周悦 段媛 Zhou Xiang(School of Management,Chengdu University of Traditional Chinese Medicine,Chengdu,P.R.China)

机构地区：[1]成都中医药大学管理学院,四川成都611137

出　　处：《中国卫生事业管理》2025年第2期172-176,185,共6页Chinese Health Service Management

基　　金：教育部人文社科规划基金项目“重大疫情背景下中医药网络舆情研究”(21YJAZH016);四川省中医药文化与中医药发展研究中心重点项目“成都市青少年中医药文化认同评价与提升策略研究”(ZYYWH2024010);四川省中医药管理局管理及决策项目“数字时代背景下四川省居民中医药健康信息素养评价与促进策略研究”(2023MS507);四川中医药大健康产业发展与乡村振兴研究中心重点项目“四川中医药健康产业高质量发展评价与对策研究”(DJKWT202301);成都中医药大学杏林学者青基人才项目(QJRC2022056)。

摘　　要：目的:研究我国中老年慢病患者卫生服务利用情况,探究影响其卫生服务利用的关键因素,为政府和卫生管理部门提高中老年慢病患者卫生服务利用率、完善医疗卫生服务体系、促进中老年慢病患者健康提升提供参考。方法:以Andersen理论模型为基础,采用2020年中国健康与养老追踪调查数据,运用卡方检验、Logistic回归分析等方法进行数据分析。结果:7614例调查对象中,四周就诊率为23.3%,一年住院率为20.4%;不同性别、受教育程度、消费水平、吸烟、饮酒、自评健康状况、慢病数量、ADL、抑郁及睡眠情况的中老年慢病患者在门诊和住院卫生服务利用上存在显著差异(P<0.05);自评健康状况、慢病数量、ADL、吸烟、饮酒、消费水平等因素显著影响中老年慢病患者的门诊和住院卫生服务利用。结论:针对不同群体在医疗卫生服务需求上的差异,提供个性化、精准的医疗卫生服务;重点关注年龄较大、自评健康状况差、慢病数量多、ADL受限、抑郁的中老年慢病群体,推动慢病数据库的建立;对重点人群定期开展健康监测,将心理健康纳入健康监测的范畴,加强健康宣教,推行家庭医生服务精准匹配健康需求。Objective To study the utilization of health services for middle-aged and elderly patients with chronic diseases in China,explore the key factors affecting the utilization of health services,and provide reference for the government and health management departments to improve the utilization rate of health services for middle-aged and elderly patients with chronic diseases,improve the medical and health service system,and promote the health of middle-aged and elderly patients with chronic diseases.Methods Based on Andersen's theoretical model,data of China Health and Retirement Longitudinal Study in 2020 were analyzed with chi-square test,Logistic regression analysis and other methods.Results Among the 7614 respondents,the four-week visit rate was 23.3%,and the one-year hospitalization rate was 20.4%.There were significant differences in the utilization of outpatient and inpatient health services among middle-aged and elderly patients with different gender,education level,consumption level,smoking,drinking,self-rated health status,number of chronic diseases,ADL,depression and sleep(P<0.05).Self-rated health status,number of chronic diseases,ADL,smoking,drinking,consumption level and other factors significantly affected the utilization of outpatient and inpatient health services in middle-aged and elderly patients with chronic diseases.Conclusion It is suggested for the government to provide personalized and accurate medical and health services for different patients according to the differences in medical and health service needs of different groups,focus on the elderly,poor self-rated health status,a large number of chronic diseases,ADL-limited and depression elderly chronic disease groups,promote the establishment of a chronic disease database,carry out regular health monitoring for key populations,include mental health in the scope of health monitoring,strengthen health education and promote family doctor services to accurately match health needs.

关 键 词：慢性病 卫生服务利用 CHARLS 

分 类 号：R197[医药卫生—卫生事业管理]