上海市老年人口体检行为的群体差异及政策启示

A Study of the Elderly People's Different Circumstances about Physical Examinations in Shanghai and Policy Proposals

科学识别老年人口健康意识和健康行为的群体差异是老年化社会公共卫生服务精准化发展的基础。以上海为案例城市,通过625份老年人口的调查问卷,分析了不同性别、年龄、居住状况、社会经济地位、城乡区位、户籍地归属等老年人口定期体检行为的群体差异。研究表明:各类社会经济属性的老年群体在是否进行定期体检、体检的时间间隔以及费用来源方面存在明显差异。在我国目前以市场化为导向的医疗体制改革中,优势社会群体相对得到更好的医疗保健服务与保障。结合社区调研访谈,建议在老年人口免费体检政策方面实行"基于收入评估"或"基于医保待遇评估"的差异化措施,整体提升全社会的老年人口健康水平,缓解全社会健康不平等问题。

The scientific identification of the elderly people’s differences in their consciousness of health and behaviors towards health is fundamentally important for the provision of targeted public health services in an aging society. This paper,through a survey of 625 questionnaires collected in Shanghai,has analyzed the different behaviors towards regular physical examinations of the elderly people of different ages,genders,living conditions,social and economic statuses,rural or urban locations,and registered residences. The result shows that differences are obvious among the elderly of various social and economic properties about whether to take regular physical examinations,time intervals,and source of fees. In China’s current market- oriented reform of the healthcare system,the privileged social groups enjoy relatively better healthcare services and protections. In order to generally enhance the level of health among the elderly people and alleviate inequality in healthcare service,the paper recommends that differentiated measures are taken based on income or medical insurance in making policies for free physical examinations.