中国老年流动人口初诊就医行为选择及影响因素研究

Study on the first diagnosis choice and its influencing factors of the elderly migrants in China

本文基于2017年全国流动人口动态监测数据,构建序次Logistic回归模型,综合分析个体因素、经济因素、社会因素和流迁因素分别对乡—城、城—城和全部老年流动人口初诊就医行为的影响。研究结果显示,老年流动人口初诊就医行为的选择存在不同程度的健康风险,乡—城和城—城老年流动人口受年龄、自评健康、收入、就业状态、生活状况、医保参保情况、本地健康档案建立情况、迁入地区、首次流动与否和家庭化流动与否等多种因素的不同影响。对此,应进一步完善基本医疗卫生保障制度,加快推进异地报销结算进程;应加快中西部地区和东北地区的医疗卫生事业基础设施的建设步伐;应重点关注农业户口的老年流动人口,给予医疗上的政策倾斜;全面提升流动老年人口的基本公共卫生知识素养,让老年流动人口的初诊就医行为更加科学,进一步降低老年流动人口所面临的健康风险。以此助力《"健康中国2030"规划纲要》战略目标的实现。

Based on the data of from 2017 migrant population migration dynamic monitoring survey in China,the paper constructs the ordinal logistic regression model to comprehensively analyses the impacts of individual factors,economic factors,social factors and migration factors on the first diagnosis and treatment behavior of rural-urban,urban-urban elderly migrants.The results show that there are different degrees of health risks in the choice of the elderly migrants’first diagnosis and treatment behavior.The rural-urban and urban-urban elderly migrants are affected by many factors,such as age,self-rated health,income,employment status,living conditions,medical insurance coverage,local health records,immigration area,first-time migration and family migration.To help to make the strategic goal of"Healthy China 2030 Planning Outline"come true,some suggestions are put forward at last.