医疗服务可及性对老年人健康的影响——基于CLHLS数据的分析

基于中国老年健康影响因素跟踪调查(CLHLS)2014年的数据,采用OLS回归模型分析医疗服务可及性对老年人健康产生的影响。研究结果表明:医疗服务可及性对老年人健康具有显著正向影响,并且该回归结果通过了稳健性检验。借助工具变量法解决内生性问题后,结果仍然显著。在此基础上,探讨影响医疗服务可及性的因素。从医疗服务需求方角度来看,经济压力是导致医疗服务不可及的主要原因;从供给方角度来看,医疗服务机构距离远限制了医疗服务可及。进一步分析发现医疗服务可及性对低收入以及距离医疗机构远的老年人影响更加显著。通过构建中介效应模型探讨医疗服务可及性对老年人健康的影响机制,发现体检作为医疗服务利用的一种方式能够发挥部分中介作用。因此,文章提出提升医疗服务经济可及性、空间可及性并重视体检服务利用的建议。

Impact of medical service accessibility on the health of the elderly: Analysis based on CLHLS data

This paper is aimed at analyzing the impacts of medical service accessibility on the health of the elderly based on the 2014 data of CLHLS in China, using OLS regression model. The study results showed that medical service accessibility has a significant positive impact on the health of the elderly, and the regression results passed the robustness test. After solving the endogenous problem with instrumental variable method, the results were still robust. On this basis, the influencing factors of medical service accessibility were discussed. From the perspective of demand side, the lack of money or being broke is the main reason for the inaccessibility to medical services. From the supply side, the household-to-hospital location restricts the access to medical services. Further analysis found that access to medical services had a more significant impact on the elderly with low income and on those who live far from medical institutions. Mediating effect model was constructed to explore the influence mechanism of medical service accessibility on the health of the elderly, and it was found that physical examination can play a part of mediating role in terms of medical service consumption. Therefore, some suggestions were put forward such as to improve economic and spatial accessibility of medical services and attach great attention to the utilization of physical examination services.