流动老年人健康状况及医疗服务利用影响因素分析

目的:了解我国流动老年人健康状况及医疗服务利用现状,分析流动老年人医疗服务利用的影响因素,为提高流动老年人健康状况提供建议。方法:使用"2015年全国流动人口卫生计生动态监测调查"数据,以Anderson模型为理论框架,使用两分类Logistic回归模型对医疗服务利用影响因素进行实证分析。结果:5 164名流动老年人中,健康或基本健康、患有医生确诊的高血压或糖尿病的流动老年人比例分别为88.57%、16.00%;年龄、家庭收入、本地朋友数量及是否患有慢性病对平时生小病是否就医有影响(P0.05);年龄、基本医疗保险、本地朋友数量、自评健康状况及是否患有慢性病对住院服务利用有显著影响(P0.05)。建议:"三保合一"有望改善流动老年人医疗保险保障作用;加强流动老年人家庭及社会支持建设;做好预防医疗服务具有较好成本效益;关注流动老年人医疗服务利用公平性。

Analysis on health status and medical service utilization among the migrant elderly in China

Objectives:To understand the health status and the utilization of medical services of the migrant elderly in China, analyze the influencing factors of the utilization of medical services, and provide policy basis and recommendations for improving their health. Methods:The data of Dynamic Monitoring Survey Data of the National Migrant population in 2015 was used, the Anderson Behavior Model was used as the theoretical framework, and binary Logistic regression model was used to analyze the influencing factors of medical service utilization. Results:Among 5164 the migrant elderly, 4574 were healthy or basically healthy, accounting for 88.57%; 1117 had hypertension or diabetes diagnosed by doctors, accounting for 16.00%; age, family income, the number of local friends and chronic diseases had an impact on the medical service utilization when they had ailments (P<0.05); age, basic medical insurance, number of local friends, self-reported health status and whether or not had chronic disease had significant effects on the utilization of in-patient services (P<0.05). Suggestions:combination of different health insurances is expected to improve the role of health insurance of the migrant elderly; family and social support construction among of the migrant elderly need to be strengthened; strengthening preventive medical services are cost-effective; the utilization of medical services of the migrant elderly need to remained equity.