Analysis Of The Utilization And Influencing Factors Of Medical Services For The Elders In Rural Areas

The worsen of elders’ health condition bring about their higher demand of medical service, however, studies show that elders especially elders in rural area facing the contradiction of high need& low demand, quite a few elders’ demand of medical service can not be satisfied. This study based on the survey data of Jiangsu Province, analyzed the situation of medical service demand and utilization and the influence factors of elders’ utilization of medical service of the elders in rural areas,and compared them with non-elders’,summarized the characteristics of the influence factors of eldes’medical service demand and utilization, had the certain practical significance to improve and perfect rural medical and health system and meet the needs of the rural elders’health service demand.The first part of empirical analysis takes takes self-evaluation health status, morbidity rate of chronic diseases,the number of sick in last year etc. as index,empirical analyzed the situation of medical service demand and utilization of elders in rural areas,and compared it with non-elders’. The results of descriptive statistics showed that, health of elders was worse than non-elders’,morbidity rate of chronic diseases was higher than non-elders’, and the elders’health was influenced more by per-capita family income than non-elders’. Low income elders were not only in a weak position in wealth but also in health. Meanwhile the utilization situation of elders was worse than non-elders’, the rate of unavailability of treatment and hospital was higher than non-elders’. County hospital and township hospital were the main medical organization for rural residents, and along with the increasing of income,elders and non-elders’ both prefer to choose better class of medical organization.The second part of empirical analysis takes when elder got ill whether they visit the hospital, their choosing of medical organization and medical expenditure as index, established the two-part model and multinomial logit model to analysis the main influence of the medical service utilization of elders in rural area. Outpatient visits logistic probability model results show that per-capita family income, whether to participate in the new rural cooperative medical system, severity of the disease, self-evaluation health status, whether to suffer from a chronic disease and regional variables were the main influence of the medical service utilization of elders visit decision; while marital status, family burden rate,severity of the disease,and regional variables etc. had a remarkable influence on the non-elders’ visit decision. Medical expenditure model results show that education, per-capita family income, severity of the disease and regional variables were the main influence of the medical expenditure of elders; and severity of the disease and regional variables were the main influence for non-elders. Medical organization choosing model results show that sex,age and regional variables had a remarkable influence on elders’ medical organization choosing;and sex, marital status, severity of the disease,regional variables and the interaction of severity of the disease and per-capita family income had a remarkable influence on non-elders’medical organization choosing.Taken together,we can get the follow conclusions:(1) severity of the disease was the most important and commom factor which influenced elders and non-elders’ utilization of medical service. Along with thedisease becomes more serious, whether the elders or non-elders, the rate of visits and medical expenditure were improved significantly, meanwhile non-elders preferred to choose better class of medical organization.It shows that elders and non-elders in rural area both have strong sense of risk aversion,to get rid of diseases and gain health,their utilization of medical service will will increase significantly. (2) Compared with the non-elders, the utilization of medical service of elders in rural area was influenced more by economic factors. The increase of per-capita family income increased not only the probability of elders’ visits,but also their medical expenditure and the proportion of their choosing of better class of medical organization.As the most important medical and health care system in rural area, the new rural cooperative medical system substantially improved the utilization of medical service of elders.(3)The utilization of medical service of elders showing significant regional differences,elders in sunan and subei were more inclined to visit the hospital than elders in suzhong,while elders in suzhong had higher expenditure;elders in sunan and suzhong were more inclined to choose better class of medical organization.