医疗和养老保障对高龄失能老年人医疗服务利用影响的研究

Research on the impact of medical insurance and pension security on medical services utilization for the elderly with disability

目的:分析医疗保险和养老保障对高龄失能老年人医疗服务利用的影响。方法:利用2018年中国老年健康影响因素跟踪调查(CLHLS)数据,在社会生态理论基础上构建两部模型进行分析。结果:医疗保险与门诊医疗服务就诊概率呈显著正相关,新农合对高龄失能老年人门诊医疗服务利用水平的影响较住院更为显著,养老保障能够显著促进失能老年人医疗服务利用,日常无人照料的失能老年人平均住院概率低,但是条件期望费用与非条件期望费用均相对较高。结论:建议持续加大对失能老年人的医疗与养老保障支持力度以缓解其医疗负担;重点加强对经济状况较差和无人照料的高龄失能老年人帮扶与健康管理,以有效满足其医疗服务需求。

Objective:To analyze the impact of medical insurance and pension security on the utilization of medical services by the disabled elderly.Methods:By using data from the 2018 Chinese Longitudinal Healthy Longevity Survey(CLHLS),we constructed two models on the basis of social ecological theory and performed analysis.Results:Medical insurance was significantly and positively correlated with the probability of outpatient visits.The impact of New rural cooperative medical scheme on the utilization level of outpatient medical services by the elderly with disability was more significant than its impact on the utilization level of hospitalization services.Pension security significantly enhanced the utilization of medical services by the elderly with disability.The average probability of hospitalization of the unattended disabled elderly was low,but the conditional and unconditional expected expenses were relatively high.Conclusions:It is recommended to continuously increase the support for medical insurance and pension security for the elderly with disability to alleviate their medical burden,and to focus on strengthening the support and health management for the elderly who are financially disadvantaged and unattended to effectively meet their medical service needs.