| With the rapid economic and social development and change of people's concept of fertility in the coming decades, there will be a rapidly growing trend in elderly population, especially the elderly population may be explosive growth. The elderly population is the high incidence of chronic disease groups, an increase aging population must bring some impacts on China's medical and health services. The new century is coming, with improvement the level of urbanization and a rapid increase of aging population size, Chongqing's economy has entered a rapid development stage. As of the end of 2014, the elderly population has accounted for 12% of the proportion of the population. In 2012, health care institutions in Chongqing have total of 133 million clinic visits passengers, which increased by 77 million passengers (growing up 6.20percents) than in 2011, the resident's average visits of health care institutions was 3.98 times. Under the background of an aging population, the demand of Chongqing's residents for health services is growing rapidly. For the elderly's chronic diseases characterized highly, Chongqing municipal government issued a special disease rule, patients with chronic diseases and serious diseases can enjoy special outpatient services. The rule has achieved some success, such as patients who are suffering from specific, whose diseases medical expenses is without fee threshold limits to mitigate and reducing the economic burden of patients, the introduction of a special disease management system is designed to help alleviate the burden on patients for medical treatment, to help patients use the health services, to help patients meet the health care needs as much as possible. Under the background of an aging population in Chongqing, This article studies the factors which affect the elderly population's health services utilization and health service needs, e specially the elderly's outpatient service utilization and needs, explores the room for the use of outpatient services among the elderly, which is able to be improved and to seek rational ways of allocation of health resources.In this paper, there are a total of seven chapters. The first chapter describes the research of the aging of our population and the elderly population suffering the incidence of chronic diseases increasingly significantly. We summarize the other previous research results on outpatient services utilization and needs under the new situation on the aging elderly population, and this chapter also describes the main contents of this paper on this basis, and the purposes, innovations and shortcomings of this paper. The second chapter describes the source of the data used in this paper, statistical models and methods of sample extraction. The third chapter describes Chongqing's medical and health development condition and does the descriptive statistical analysis of the sample, the chapter is divided into two parts, the first part introduces the Chongqing social and economic development, health services supply capacity, demand for medical services, urban and rural basic medical insurance policy. The second part describes the basic situation of the sample data, the ratio of men and women in the sample data, the proportion of the age, to participate in basic medical insurance, the level of education, disease prevention awareness, healthy lifestyle, social interaction and other major health variables were analyzed by descriptive way. The fourth chapter analyzes the factors of outpatient service demand, is divided into two major parts: The first part describes the two-week prevalence of local residents, the prevalence of chronic diseases as well as the prevalence of chronic diseases, etc. The second part uses the chi-square test to analyze gender, age, marital status, education level, household income per capita, smoking and drinking status and social interactions to find which one have a significant impact on chronic diseases. And get to know the factors which affect demand for outpatient services. The fifth chapter is the empirical research on outpatient service utilization, mainly divided into two major parts:the first part is to use the chi-square test of single factor to analyzes influencing factors, namely in terms of age, sex, with or without chronic disease, marital status, family per capita income, education level, medical insurance, the medical expenses reimbursement methods and other factors on the health service utilization. The second part is the logistic regression multivariate analysis, to analyze the impact of age, sex, with or without chronic disease, marital status, family per capita income, education level, medical insurance, the reimbursement of medical expenses on outpatient services utilization. The sixth and seventh chapters get conclusions and give recommendations, to summarize based on the outpatient services demand and utilization and to get conclusions on how to improve the utilization of outpatient services.Through the study, we found:(1) health condition, age, reimbursement way of medical expenses, level of medical care and health are the main factors in the elderly outpatient services utilization, others, such as per capita household income, education level, gender, and type of household registration have an impact on decisions of the outpatient services; (2) the impact of different health insurance on outpatient services is not the same, utilization rate of outpatient of the one who joins the urban and rural is the highest, so the urban and rural residents medical insurance to motivate patients to actively use outpatient services further; (3) improper reimbursement of medical expenses and lower economic levels will hinder the use of medical services, compared with a reimbursement of medical expenses, a higher attendance rate occurs when in real-time reimbursement, compared with the low-income, a higher attendance rate when who is high-income earners, the fact is that improper reimbursement and lower economic will result in the demand for medical services cannot be met; (4) the unified residents' treatment is higher than the attendance rate of urban residents and rural residents, the main reason is that a unified household registration reform is one of the signs of urban and rural development, registration reform also means that the public welfare of rural areas is consistent with the urban area's and gradually improvement of room for the interests of rural residents can get. With the increase of the welfare of rural residents, they will invest in their own health and their outpatient service utilization also increase much more accordingly;In this paper, we get the following conclusions:(1)chronic diseases is the main factors of the health of the elderly, social support status increasing; (2)there is great demand for outpatient services in the elderly, health status and health care are the main types of factors;(3)Elderly outpatient services in general is inadequate, there is a big potential demand;(4)primary health care institutions is the preferred mechanism for treatment of the elderly, the current flows is more reasonable;(5)increasing medical costs inhibits the growth in the use of health services.Based on the above conclusions, we give the following suggestion:(1)do a good job to build basic public health services, to strengthen the awareness of chronic disease prevention and control; (2)strengthen the mental construction of the elderly, to build multi-level social support networks for them; (3)improve the special disease management system, strengthen the management of chronic disease clinics;(4) promote the reform of the pharmaceutical market, control the excessive growth of medical costs; (5)play an important role of primary health service institutions, improve the capacity and quality of primary health care services; (6)promote the unification process insurance system for urban and rural residents, improve the level of protection of health care system for the elderly. |
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