医养结合政策试点如何影响老年人医疗服务利用行为：来自医养结合试点城市的证据

• 作者： 李子豪 ¹
• 作者单位：
  1.  南京大学-政府管理学院
• 发布时间：2024-12-13

摘要: 随着老龄化程度不断加深与慢性病患病率的攀升，我国老龄人口医疗服务与社会照料需求不断膨胀，医养结合政策对于优化老年人就医行为实现健康老龄化具有重要意义。文章使用中国健康与养老追踪调查（CHARLS）2011、2013、2015、2018年四期面板数据，在双重差分框架下考察了率先试点地区的医养结合政策对老年人就医行为的影响效果。研究发现，医养结合政策实施降低了老年人门诊医疗服务利用水平，但提升了老年人住院医疗服务利用水平。异质性分析表明医养结合对农村、低龄与空巢老年人门诊行为影响更有效，对城镇、高龄与空巢老年人的住院行为作用效果更明显。机制分析表明医养结合试点通过提升主动健康意识与降低非正式照料两条路径进一步影响老年人医疗服务利用水平。因此文章从提升医养结合服务能力、重点关注特殊群体、培育主动健康意识、衔接非正式照料等方面提出了具体的政策建议。

Abstract: With the deepening of aging and the increasing prevalence of chronic diseases, the medical and social care needs of China's elderly population are constantly expanding. The combination of medical care and elderly care is of great significance for optimizing the medical behavior of the elderly and achieving healthy aging. The article used panel data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018 to evaluate the impact of the first pilot of the integration of medical care and elderly care on the medical behavior of elderly people under a difference in differences framework. Research has found that the implementation of the integrated medical and elderly care policy has reduced the utilization level of outpatient medical services for the elderly, but has improved the utilization level of inpatient medical services for the elderly. Heterogeneity analysis shows that the combination of medical care and elderly care has a more significant impact on the outpatient behavior of rural, young, and empty nest elderly people, and a more significant effect on the hospitalization behavior of urban, elderly, and empty nest elderly people. Mechanism analysis shows that the pilot program of integrating medical care with elderly care further affects the utilization level of medical services for the elderly through two paths: enhancing proactive health awareness and reducing informal care. Therefore, the article proposes specific policy recommendations from the aspects of enhancing the ability of medical and elderly care integration services, focusing on special groups, cultivating proactive health awareness, and connecting informal care.

• 来自： 李子豪
• 分类： 公共管理学 >> 社会医学与卫生事业管理
• 稿件状态： 已投稿期刊
• 引用： PSSXiv:202412.00648 (或此版本 PSSXiv:202412.00648V1)
  DOI:10.12451/202412.00648
  CSTR:32012.36.PSSXiv.202412.00648
• 推荐引用方式： 李子豪.医养结合政策试点如何影响老年人医疗服务利用行为：来自医养结合试点城市的证据.哲学社会科学预印本平台:https://zsyyb.cn/abs/202412.00648.[PSSXiv:202412.00648V1] (点此复制)