| Objective:To analyze the effects of the utilization of preventive care services on health status by the middle-aged and elderly people in China and to clarify the relationship between the utilization of preventive care services and health status. On the basis of empirical analysis, to analysis the influencing factors of the utilization of preventive care services by the middle-aged and elderly people in China. To put forward policy recommendations aiming at these factors, so as to provide the theoretical support and practical basis to improve the health status of the middle-aged and elderly people in China.Methods:Using the China Health and Nutrition Survey (CHNS) data to track the health status of elderly in 2011 that were participated in 2009 over 45 years. After eliminating invalid data, a total of 5202 people were included in this study. Analysis the elderly in 2009 whether to accept the utilization of preventive health care services affect the health status in 2011.Treat the elderly received the utilization of preventive health care services in 2009 as treatment group. Treat the elderly do not received the utilization of preventive health care services in 2009 as control group. The difference of health status in the elderly between the two groups was compared by difference-in-difference method. The status of health in the elderly mainly through four weeks prevalence rate, BMI index、history of disease and mental health and other indicators to reflect; And in 2009 whether to accept the utilization of preventive health care services as the dependent variable,gender, age, in urban and rural areas, marital status, occupation, level of education, household per capita income, health insurance, four weeks prevalence rate and hypertension, diabetes, myocardial infarctionand other diseases history as an independent variable. To analysis the related factors affecting elderly accepted the utilization of preventive health care services. The study mainly used multivariate logistic regression, chi-square test and difference-in-difference method. The statistical software used are SPSS18.0 and SAS9.1.Results:The utilization of preventive care services in the elderly is not high, only 289 people received preventive health care services while 5202 people in the 2009 research, utilization of preventive health care services was 5.6%, far lower than other countries. Multi factor Logistic stepwise regression of preventive health care services shows, age (OR=0.404,95%CI:0.218-0.749), urban and rural (OR=2.657,95%CI:1.910~3.695)、educational level (OR=1.739, 95%CI:0.954~3.170)、health insurance (OR=1.378,95%CI:1.040~1.827)、per capita household income (OR=5.201,95%CI:3.709~7.293)、occupation (OR=0.023,95%CI: 0.003~0.170)as well as four weeks prevalence rate(OR=4.713,95%CI:3.511~6.328) for theutilization of preventive health care services was statistically significant (P<0.05). The result of the utilization of preventive health care services affecting health status shows, preventive health care utilization will reduce four weeks prevalence rate and the history of hypertension, diabetes and other diseases, and in terms of body mass index on the health of the elderly have affected.Conclusion:The utilization of preventive care services in the elderly is insufficient, and the utilization of preventive care services influencedby age, urban and rural, occupation, the level of educationl, household per capita income and medical insurance. To improve the health level of the elderly of our country comprehensively, it is necessary to improve the elderly purchase capacity of preventive care services utilization by more ways. Strengthen the health education in the elderly, change its preventive care concept fundamentally, improve the efficiency of resource of allocation in preventive care services to promote urban and rural fair; Contribute to the improvement of medical insurance system, strengthen the relationship between health insurance and preventive health care services; give full play to the role of community health. |
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