Research On The Influencing Factors Of The Utilization Of Medical And Health Services For The Migrant Elderly

During the "Thirteenth Five-Year Plan" period,China's economic development has entered a new normal,the status of health in the national economy and social development has been further improved,people's health awareness has gradually increased,and the level and diversified needs of medical and health services have been continuously improved.China's "Healthy China" strategy requires the comprehensive establishment of a basic medical and health system with Chinese characteristics,improving national health policies,and accelerating the development of aging undertakings and industries.With the acceleration of the aging population,the advancement of new urbanization,and the improvement of the stability of the floating population's residence,population mobility has entered a new stage of family-based mobility,and the size of the mobile elderly is expanding and will continue to grow.The expansion of the floating elderly places higher demands on medical and health service resources,and the "static publicity" causes the floating elderly to face the double predicament of public fracture and imbalance.Analyze the promotion factors among the influencing factors of the utilization of medical and health services of floating elderly people,and find out what other obstacles exist.It can improve the utilization of public medical and health resources by floating elderly people,improve the health and well-being of floating elderly people,and achieve basic medical and health care.The goal of equalizing services,promoting social fairness and justice,and finally achieving the strategic goal of "Healthy China" have certain practical value.This study is based on Anderson's medical and health service utilization model and Grossman's theoretical model of health capital,using floating elderly people as the research object,using questionnaire survey to discuss the status and influencing factors of floating elderly medical and health service utilization.The results of the study show that:(1)Generally speaking,the education level and overall medical insurance coverage rate of the floating elderly are low,economic dependence is strong,medical health service utilization initiative is low,and awareness of preventive health care is weak.The specific performance is as follows: 63.9% of the floating elderly have primary school education or below;the sample participation rate of the floating elderly is 85.8%,which is still 9.2percentage points lower than the national average in 2018;more than one third of floating elderly people mainly rely on their children and other support methods to maintain their lives;only 29.3% of floating elderly people choose to see a doctor when they are usually sick,and should be hospitalized in the past year without hospitalization rate(37.7%)ismuch higher than the fifth.The national health service survey of elderly urban and rural residents(17.1%)and the rate of participating in free health examinations in the past year(17.8%)are far less than the fifth national health service survey of elderly people in urban areas(59.6%).(2)The results of single factor analysis show that there are significant differences in the utilization levels of medical and health services among floating elderly people with different propensity characteristics,enabling characteristics and demand characteristics.Older age(Predisposing),higher education level(Predisposing),city-to-city mobility(Predisposing),smaller flow range(Predisposing),better self-assessment economic status(Enabling),the closer the distance to medical treatment(Enabling),the worse the self-assessed health status(Need),the higher the level of outpatient service utilization of mobile elderly people with chronic diseases(Need);the older the age(Predisposing),the higher education level(Predisposing),spouses(Predisposing),city-to-city mobility(Predisposing),smaller flow range(Predisposing),better self-assessed economic status(Enabling),participation in basic medical insurance(Enabling),self-assessed of poorer health status(Need),and a higher level of hospital service utilization for mobile elderly people with chronic diseases(Need);women(Predisposing),higher education level(Predisposing),city-to-city mobility(Predisposing),smaller flow range(Predisposing),participation in basic medical insurance(Enabling),the worse self-assessed health status(Need),and a higher level of the use of preventive health care services for floating elderly people with chronic diseases(Need).(3)Regression analysis results show that the influencing factors of outpatient,inpatient and preventive health care service utilization of floating elderly people are both common and different,and the inclination characteristics,enabling characteristics and demand characteristics have different effects on different service utilization projects.For the use of outpatient services for mobile elderly,the tendency characteristics include age,education level,household registration type and mobility range,enabling characteristics to self-evaluate the economic status and distance to medical treatment,and requiring characteristics to self-evaluate the health status and patients with chronic diseases.The situation is the main influencing factor;for the use of floating elderly hospitalization services,age,education level,marital status,household registration type and mobility range are preferred in the characteristics,and self-evaluation of economic status and basic medical insurance are required in the enabling characteristics.The self-assessment of health status and chronic disease in the characteristics are the main influencing factors;forthe use of preventive health care services for floating elderly people,the education level,household registration type and mobility range in the trend characteristics enable the basic medical insurance in the characteristics,the self-assessment of health status and the condition of chronic diseases in the characteristics of need are the main influencing factors.Based on the results of data analysis and the overall level of education and medical insurance coverage of migrant elderly people is low,economic dependence is strong,medical service utilization initiative is low,awareness of preventive health care is weak,there are mechanical barriers to medical treatment from other places,and primary medical institutions.In terms of insufficient trust and other issues,this study proposes the following countermeasures and suggestions:(1)Improve the national health security system: multiple strengthened medical insurance systems,innovative basic medical insurance operation management mechanism,optimize the work system of medical and health services;(2)Strengthen supporting policies:expand the source of income of floating elderly people,establish community-based pension and elderly activity centers,and do a good job of family assistance intervention with the help of grid management.