中国老年人就医行为城乡差异研究

发布时间：2018-11-10 18:18

【摘要】：中国于2000年进入老龄化社会且老龄化速度和程度不断加剧,老年人医疗费用支出逐年增加。改变人们对疾病的认识、加强疾病预防、优化就医行为,可以减少对医疗卫生服务的依赖与消耗,是缓解老龄化所带来的医疗卫生费用快速增长问题的有效途径。本研究以韦伯关于不同社会阶层具有不同生活方式的思想和布迪厄的社会实践理论为指导,认为个体的就医行为作为人类社会行为的一种具体形式,是在特定群体社会背景和文化下形塑而成的,不同生活环境中的个体间存在就医行为差异。在中国“城乡二元”的社会结构下,处于城市和农村这两种完全迥异生活环境中的老年人具有各自不同的就医行为。在实证研究中依托健康信念模型,对2006年和2010年两次中国城乡老年人口状况追踪调查结果进行数据分析,分别呈现城市和农村老年人群的就医行为特征、两者之间的差异及其内在原因。通过描述性分析和二元回归分析,研究发现如下：1.农村老年人患病后的就诊率不及城市老年人；受经济状况约束,农村老年人在就医方式选择过程中,更加偏好花费少或报销比例高的就医方式；农村老年人对医疗服务机构质量未表现出明显偏好和要求；农村老年人健康状况越差者,患病后进行治疗的可能性反而越小。2.农村老年人就医同质化倾向明显,城市老年人群体间差异较大。农村老年人在患病后,选择进行治疗的可能性在不同经济状况和受教育程度群体间未呈现明显差异。城市老年人在患病后选择进行治疗的可能性因受教育程度和经济状况影响而呈现明显的群体差异,且群体间分化较大。3.2006年—2010年期间,“新型农村合作医疗”政策的实施提高了老年人患病后就医的可能性,但尚未能弥合城市和农村老年人患病后就诊率上的差距,城市老年人患病后的就诊率依旧较农村老年人高。因此,医疗保障政策的实施和完善可以考虑“弱者优先”的理念,根据城乡老年人各自就医行为的现状和二者间的差距,进行一定倾斜和调整,使弱者的健康状况得以改善。
[Abstract]:China entered an aging society in 2000, and the speed and degree of aging is increasing. Medical expenses for the elderly are increasing year by year. Changing people's understanding of diseases, strengthening disease prevention and optimizing medical behavior can reduce the dependence and consumption of medical and health services, which is an effective way to alleviate the rapid increase of medical and health costs caused by aging. Guided by Weber's thought that different social strata have different ways of life and Bourdieu's theory of social practice, the author thinks that individual medical behavior is a concrete form of human social behavior. It is shaped under the social background and culture of specific groups, and there are differences in medical behavior among individuals in different living environments. Under the social structure of "urban-rural duality" in China, the elderly in the two completely different living environments, urban and rural, have their own different behaviors of seeking medical treatment. In the empirical study, based on the health belief model, the data analysis was carried out on the results of two tracking surveys of the elderly population in urban and rural areas in 2006 and 2010, respectively, showing the characteristics of the medical behavior of the elderly population in urban and rural areas. The difference between the two and its internal reasons. Through descriptive analysis and binary regression analysis, the results are as follows: 1. The medical treatment rate of the elderly in rural areas was lower than that in the urban areas, and the rural elderly people preferred the less cost or the higher proportion of reimbursement in the process of choosing the way of medical treatment, which was restricted by the economic situation. The elderly in rural areas did not show obvious preference and demand for the quality of medical service institutions, and the worse the health status of the rural elderly, the less likely they were to be treated after the illness. 2. The tendency of the elderly in rural areas to seek medical treatment is homogenized, and there is a great difference among the urban elderly groups. There was no significant difference in the possibility of choosing treatment among the groups with different economic status and education level. The possibility of treatment for the elderly in urban areas was significantly different due to their educational level and economic status, and the differentiation between groups was significant. 3. During the period from 2006 to 2010, there were significant differences among different groups. The implementation of the policy of "New Rural Cooperative Medical system" has increased the possibility for the elderly to seek medical treatment after they become ill, but it has not yet bridged the gap between the medical attendance rates of the elderly in urban and rural areas. The visiting rate of the elderly in urban areas is still higher than that in the rural areas. Therefore, the implementation and perfection of medical security policy can consider the idea of "the weak take precedence", according to the current situation of the old people's medical treatment in urban and rural areas and the difference between the two, we can make certain inclination and adjustment, so that the health condition of the weak can be improved.
【学位授予单位】：西南财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R592;C913.6

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