中国老年人健康需求影响因素——基于医疗费用视角的分析

The influence factors of Chinese elderly healthy demand——Based on the analysis of medical expenses perspective

目的从医疗费用的视角了解我国老年人健康需求的影响因素。方法以Grossman模型为指导,基于2011年中国老年健康影响因素跟踪调查数据(CLHLS),根据本次调查的医疗支出中位数和全国家庭灾难性卫生支出将医疗支出划分为低、中、高三个等级,并以衡量健康需求的自评健康为因变量,个人基本情况、家庭基本情况和卫生服务利用为自变量,采用有序probit回归模型方法分析老年人健康需求的影响因素。结果共获得调查老年人8 983例,其中低、中、高医疗支出者分别占53.90%,16.78%和29.32%。总体上,旅游、养老保险、医疗服务及时性、经济状况、体检以及由医保付费是中国老年人健康需求的影响因素。不同支出水平下的老年人健康需求影响因素具有其相应的特点。结论加强低医疗支出老年人的医疗服务可及性,提高医保覆盖率及报销比,很大程度上能满足老年人的健康需求。同时,倡导积极锻炼对促进老年人身体健康具有积极的意义。

Objective To study the factors of elderly healthy demand in China by the perspective of medical expenses,in order to provide evidence-based decision-making basis for government. Methods With Grossman healthy demand model as a guide,based on the data from the Chinese Longitudinal Healthy Longevity Survey( CLHLS) in 2011,dividing medical expenses into low,medium and high level by the median of medical expenses and national household catastrophic health expenditures,self-rated health which was a measure of healthy demand was used as the dependent variable,and the basic personal situation,the basic situation of the family and health services as independent variables. Results The sample was 8 983 and the three levels of low,average,high medical expenses accounted for 53. 90%,16. 78%and 29. 32% respectively. Overall,the Chinese elderly healthy demand was influenced by factors such as travel,pension,timely medical services,economic status,physical examination and medical expenses paid by medical insurance. At different levels of payments,factors of Chinese elderly healthy demand had their respective characteristics. Conclusions Strengthening the health services accessibility of low medical expenses for the elderly and enhancing coverage and reimbursement ratio of medical expenses would largely meet the healthy demand of the elderly. At the same time,promoting active exercise would have a positive significance to the health of the elderly.