社区居家养老服务利用对老年人医疗费用的影响研究

Study on the Influence of the Utilization of Community Home-based Care Services on the Medical Expenses of the Elderly

目的:分析各类社区居家养老服务利用对老年人医疗费用的影响,为完善社区居家养老服务,推动积极老龄化、健康老龄化的实现提供参考依据。方法:基于2018年中国老年健康长寿影响因素跟踪调查数据,采用多元线性回归和倾向得分匹配法分析各类社区居家养老服务利用对老年人医疗费用的影响。结果:生活照料服务、医疗保健服务、精神文化服务和调解维权服务的利用率分别为12.21%、52.12%、24.12%和33.23%。多元线性回归分析结果显示,除各类社区居家养老服务外,老年人的城乡居住、年龄、自评健康、饮酒、每年体检、家庭年收入和过去两年内患重病次数是其医疗费用的显著影响因素。倾向得分匹配法分析结果显示,生活照料服务利用的平均处理效应值范围为0.685~0.803,医疗保健服务利用的平均处理效应值为0.405。结论:老年人对社区居家养老服务的利用率较低,生活照料服务利用和医疗保健服务利用会显著提升老年人的医疗费用,而精神文化服务利用和调解维权服务利用对老年人的医疗费用无显著影响。

OBJECTIVE To analyze the impact of various community home-based care services utilization on the medical expenses of the elderly,so as to provide references for improving community home-based care services and promoting the realization of active aging and healthy aging.METHODS Based on the data of Chinese Longitudinal Healthy Longevity Survey in 2018,multi-factors linear regression and propensity score matching were used to analyze the impact of the utilization of various community home-based care services on the medical expenses of the elderly.RESULTS The utilization rates of daily care services,medical care services,spiritual and cultural services and mediation and rights protection services were 12.21%,52.12%,24.12%and 33.23%.The results of multi-factors linear regression analysis showed that in addition to various community home-based care services,the elderly’s residence,age,self-rated health,drinking,annual physical examination,annual household income and the number of serious diseases in the past two years were significant influencing factors of their medical expenses.The results of propensity score matching analysis showed that the average treatment effects on treated of daily care services utilization ranged from 0.685 to 0.803,and the average treatment effects on treated of medical care services utilization was 0.405.CONCLUSION The utilization rate of community home-based care services for the elderly is low.The utilization of daily care services and medical care services will significantly increase the medical expenses of the elderly,while the utilization of spiritual and cultural services and mediation and rights protection services have no significant impact on the medical expenses of the elderly.