| ObjectivsBased on The Behavioral Model of Health Services Use,to describe the medical need and utilization among empty-nest aging population in China,to analyze influencing factors of medical utilization among these population,and to promote the utilization of medical service and to provide evidence for the improvement of medical service system for elderly people in China.MethodsThis study primarily adopts the method of quantitative analysis.Firstly,sort out the relevant research about the concept of empty-nest aging population and the utilization of medical service by literature research.Secondly,analyze basic situation and the medical need and utilization of respondents by descriptive statistic method.Then,analyze the difference of the medical utilization among empty-nest aging population under the framework of The Behavioral Model of Health Services Use by chi square test.Finally,build a multiple regression analysis model to empirically study the relevant influencing factors which may affect the medical utilization.Results1.The empty-nest phenomena are widespread across China.Empty-nest population mainly consist of single elderly people(34.1%)and elderly couples(65.0%).The main characteristics of empty-nest population are these below:male,married,low educational,living in the rural area,unemployed or engaged in agricultural work,suffering from chronic diseases,poor self-rated health status,less economic support from children,less family income,low life satisfaction,participating in the New Rural Cooperative Medical System.2.In 2015,among the empty-nest population in China,the 4-week prevalence rate of diseases was 30.83%,the prevalence rate of chronic diseases was 73.89%,the 4-week outpatient rate was 20.80%,the hospitalization rate was 18.20%,the 4-week rate of having illnesses but not visiting a doctor was 34.19%,the rate of needing hospitalization but not taking was 31.47%.The reasons for having illnesses but not visiting a doctor were mainly that feeling it’s not severe,having no money to see a doctor,already under treatment.The reasons for needing hospitalization but not taking were mainly that having no money,not willing to go to the hospital,problem too serious or medical quality too poor.3.In the aspect of the utilization of outpatient medical services,the results of logistic regression indicated that compared to those empty-nest population who had these characteristics below:60～69 years old,no chronic disease,good self-rate health status,no depression,not participating in social activities,those who had other characteristics below:above 80 years old(OR=0.672)had a lower chance to use outpatient service,while those who had other characteristics below:having 2 diseases(OR=1.431),having at least 3 diseases(OR=1.852),neutral self-rated health status(OR=1.780),poor self-rated health status(OR=1.896),severe depression(OR=1.632),participating social activities(OR=1.274)had a higher chance to use outpatient service.Compared to those single elderly people who had these characteristics below:60～69 years old,no depression,not participating in social activities,those who had other characteristics below:above 80 years old(OR=0.622)had a lower chance to use outpatient service,while those who had other characteristics below:severe depression(OR=1.896),participating social activities(OR=1.325)had a higher chance to use outpatient service.Compared to those elderly couples who had these characteristics below:no chronic disease,good self-rate health status,no medical insurance,those who had other characteristics below:having 2 diseases(OR=1.763),having at least 3 diseases(OR=2.360),neutral self-rated health status(OR=2.028),poor self-rated health status(OR=2.321),participating in other medical insurances(OR=1.756)had a higher chance to use outpatient service.4.In the aspect of the utilization of in-patient medical services,the results of logistic regression indicated that compared to those empty-nest population who had these characteristics below:60～69 years old,no chronic disease,good self-rate health status,intact activity of daily life,no economic support from children,no medical insurance,those who had other characteristics below:70～79 years old(OR=1.402),above 80 years old(OR=1.560),having at least 3 diseases(OR=1.706),neutral self-rated health status(OR=1.597),poor self-rated health status(OR=2.242),damaged activity of daily life(OR=1.792),high economic support from children(OR=1.364),participating in urban employee medical insurance(OR=1.666),participating in other medical insurances(OR=1.475)had a higher chance to use outpatient service.Compared to those single elderly people who had these characteristics below:unemployed,no disease,good self-rate health status,intact activity of daily life,those who had other characteristics below:engaged in agricultural work(OR=0.277)had a lower chance to use outpatient service,while those who had other characteristics below:having at least 3 diseases(OR=1.690),neutral self-rated health status(OR=1.885),poor self-rated health status(OR=2.553),damaged activity of daily life(OR=1.706),had a higher chance to use outpatient service.Compared to those elderly couples who had these characteristics below:no chronic disease,good self-rate health status,intact activity of daily life,no depression,no medical insurance,those who had other characteristics below:70～79 years old(OR=1.340),above 80 years old(OR=1.562),having at least 3 diseases(OR=1.695),neutral self-rated health status(OR=1.544),poor self-rated health status(OR=2.047),damaged activity of daily life(OR=1.785),mild depression(OR=1.351),participating in urban employee medical insurance(OR=1.742)had a higher chance to use outpatient service.Conclusions1.The empty-nest phenomena are widespread across China.They are mainly from rural areas.They mainly consist of single elderly people and elderly couples,and the latter are more than the former.2.The 4-week outpatient rate of empty-nest aging population in China was a little bit smaller than that of ordinary old people,the hospitalization rate of empty-nest aging population was larger than that of ordinary old people.The reasons for not using medical services are mainly the knowledge about illness and economic status.3.All the factors from predisposing factors,needing factors and enabling factors can affect outpatient and in-patient service utilization of empty-nest aging population.Older,having more chronic diseases,poor self-rated health status,severe depression,participating social activities contributed to outpatient services.Older,having more chronic diseases,poor self-rated health status,damaged activity of daily life,high economic support from children,participating urban employee medical insurance or other medical insurances contributed to in-patient services. |
PDF Full Text Request