Study On Influencing Factors For Medical Service Utilization About Urban Middle-aged And Elderly Chronic Disease Patients

The number of middle-aged and elderly population increases with the increase of the elderly population.Middle-aged and elderly people are affected by the metabolism of the human body,and their physical functions continue to decline.It has become the norm to suffer from two or more chronic diseases.The increased demand for medical resources has caused a surge in medical expenditures,which has continuouslincreased the economic burden of residents and the country.In recent decades,the growth rate of China’s medical expenditure far exceeded the growth rate of the GDP,which had a negative impact on the overall economic development of the country.Under the dual promotion of urbanization and population aging,the medical service utilization of the urban elderly population has gradually become that the focus of attention.Therefore,how to increase the utilization rate of medical services for middle-aged and elderly people in cities by adjusting urban medical supply and reducing personal medical economic burden is of great significance to the improvement of personal life quality andnational economic development.This paper studies the 2015 national statistical data of the China Health and Pension Tracking Survey(CHARLS),draws on Andersen’s medical service utilization behavior model to screen out four categories of factors that may have an impact on medical service utilization,and uses Heckman’s two-step method to test the data.Then use Cragg’s two-part model,Firstly,the Probit model is used to determine the probability of the occurrence of outpatient visits(outpatient visits and inpatient visits),and then the OLS estimation model is used to perform regression analysis on the influencing factors of medical expenditures(outpatient visits and inpatient visits).The main research conclusions are as follows:(1)In terms of outpatient visit behavior,female patients,patients with higher education level and patients with better self-assessment health,and urban chronic disease patients with smoking and drinking behaviors have a higher probability of outpatient visits.The degree is high and the utilization rate of medical services is higher.(2)In terms of outpatient medical expen-diture,patients with higher education level,patients with poor self-assessment health and smoking patients have higher outpatient medical expenditure and higher utilization rate.(3)In terms of hospitalization,the higher the age,the lower the education level,the smaller the family size,the insured patients,and the patients with drinking behavior,the higher the hospitalization probability and the higher the medicalutilization rate.(4)In terms of hospitalization medical expenditures,patients with lower education level,patients with drinking behaviors,and patients with poor emotional status have higher hospitalization medical expenditures and higher utilization rate of medical services.According to the empirical conclusions,the paper’s related recommendations are as follows : First of all,strengthen the prevention and treatment of the chronic diseases and should raise residents’ health awareness.Secondly,strengthen the public psychological construction.Thirdly,improve the level of primary medical services and strengthen the trust of community residents.And then,improve the primary health care policy.