| At present,the degree of aging in China is constantly increasing,among which the disabled and the half-disabled elderly account for nearly 20% of the elderly,and the demand for care resources is also rising.Under the background of the traditional concept of "having children to support one in old age" and the lack of perfect public care system,intergenerational care remains the mainstay of care for the disabled.Compared with the normal elderly,the disabled elderly have poor self-care ability and the demand for daily care and medical services is more urgent.In this reality,it is worth discussing whether intergenerational care support can reduce the use of medical services by improving the health of disabled elderly,or increase the use of medical services by reducing medical barriers for the disabled elderly.This paper adopted the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)in 2014 to research the disabled elderly over 65 years old.We used the probability of seeking medical treatment and medical expenses as dependent variable,whether there is intergenerational care support or not and the intensity of care as independent variable.According to Andersen,we chose predisposing characteristics,enabling resources and need factors as control variables.Considering that there may be endogeneity between intergenerational care and medical service utilization,we adopt Recursive Bivariate Probit model and IV-Probit to analyse.Since family-level variables affect the use of medical services by influencing family care decisions,we chose whether the oldest child is over 60 years old and the number of living daughters and whether there is a living daughter as instrumental variables,try to alleviate endogenous problems to some extent.The empirical results show that:(1)There is a complementary relationship between intergenerational care and the utilization of medical services for disabled elderly.Intergenerational care support can reduce the barriers to medical treatment,alleviate the problem of "difficulty in getting medical service" on the subjective level,and increase the probability of outpatient service and hospitalization of the disabled elderly.(2)Highintensity intergenerational care releases medical needs significantly.With the increase of care time,the outpatient cost of disabled elderly will increase significantly.(3)Affected by economic conditions and medical accessibility,the probability of seeking medical treatment and medical expenses of disabled elderly in rural areas is significantly lower than those in urban areas.(4)The conflict of time allocation in caring affects whether caregivers provide intergenerational care significantly.Based on the conclusions,this paper proposes the following suggestions: Firstly,improve the policy for supporting two-child births and increase the resources of intergenerational care.Secondly,develop supportive policies for intergenerational caregivers.Thirdly,establish long-term care insurance and develop community service for home care of the elderly.Finally,strengthen the construction of basic health service system and enhance the medical accessibility of disabled elderly.The innovation of this paper lies in studying the relationship between intergenerational care and the utilization of medical services from the perspectives of whether there is intergenerational care support or not and the intensity of care,and considering the probability of seeking medical treatment and medical expenses.Because intergenerational care decision-making and the utilization of medical service may be affected by some factors at the same time,or there is the possibility of simultaneous causality between them may lead to endogenous problems.We try to overcome the endogenous problem by instrumental variable method and simultaneous equation model.In the next study,we intend to use panel data to analyze the influence of intergenerational care on the utilization of medical services for disabled elderly. |
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