A Study Of Middle-aged And Elderly Female Health Service Utilization And Influencing Factors Based On Anderson’s Behavior Model

Objective: This study uses the China Health and Retirement Longitudinal Study database to further understand the current situation of female health service utilization and influencing factors,to clarify the relationship between different influencing factors and their pathways,in order to provide a reference basis for proposing a management strategy for female health.Methods: Through literature research method,the sample of female respondents who continuously participated in the China Health and Retirement Longitudinal Study in2018 were selected,descriptive analysis and chi-square test were used to conduct univariate analysis of middle-aged and elderly women’s health service utilization,logistic regression model and decision tree model were used to explore relevant influencing factors affecting middle-aged and elderly female health service utilization,and construct a structural equation model based on Anderson’s Behavior Model to verify the pathways of the role of female health service utilization in China.Results:1.The utilization rate of health services for middle-aged and elderly women in China was 48.91%,19.84%,and16.97% for physical examination,outpatient,and inpatient health services,respectively,and 63.90% for health services.2.Univariate analysis showed statistically significant differences in utilization of medical examination,outpatient,and inpatient services by age,location,psychological status,health satisfaction,life satisfaction,local medical satisfaction,and chronic disease,P<0.05.3.The Binary Rogers Regression and decision tree results showed age,literacy,religion,income,social activities,basic medical insurance,self-rated health,self-rated health status,health satisfaction,chronic illness,and physical pain can affect middle-aged and elderly female health service utilization.4.The results of the structural equation modeling indicated that there were four pathways of action affecting the utilization of women’s health services,all of which were statistically significant: predisposing factors → enabling factors →health service utilization,predisposing factors →health service utilization,enabling factors → need →health service utilization,and need → health service utilization.The total effect absolute values of the influencing factors of health service utilization according to the standardized total effect female health service utilization in the order from largest to smallest are: need(0.851),enabling factor(0.114),predisposing factor(0.035).Conclusions and Suggestions:1.the utilization level of female health service utilization in China is still low,this indicates that not enough attention is currently being paid to the utilization of health services for the middle-aged and elderly women.2.The factors influencing health service utilization of middle-aged and elderly women in China are complex.Age,education,religion,income,social activities,local medical satisfaction,health satisfaction,self-rated health,self-rated change in health status,chronic diseases,and painful intolerable can affect health service utilization.3.Three latent variables were extracted predisposing factors,enabling factors,and need from Anderson’s Behavior Model.The fitness index of the middle-aged and elderly women health service utilization model constructed by structural equation model basically conforms to the standard,indicating that the constructed model is more reasonable.4.Predisposing factors,need,and enabling factors have both direct and partial indirect effects on health service utilization,and the interaction between these factors should be paid attention to in order to carry out female health service utilization.It is recommended to focus on female groups with lower social and economic status,to implement the policy of contracting family doctor services and chronic disease health management for the female population,to introduce special consultation services for women,and to improve women’s self-perception of health so as to improve middle-aged and elderly women’s health.