| Background The rapid growth of China’s aging population has brought attention to the issue of empty-nest elderly individuals,particularly in rural areas.Among this demographic,there is a significant prevalence of chronic diseases,with essential hypertension being the most common health problem.Rural empty-nest elderly individuals experience a significant burden of treatment due to the prolonged duration,low cure rate,and high treatment costs associated with their health conditions.In comparison to their urban counterparts,rural empty-nest elderly individuals often have limited financial resources and a lower level of health awareness,leading to more severe health issues.Despite an increasing demand for various medical services,their access to adequate healthcare remains limited due to economic constraints and other factors.Therefore,the improvement of medical service utilization among rural emptynest elderly hypertensive patients may be a crucial part of the development of healthy aging in my country.The global scholarly community has shown increasing interest in the concept of "social capital".Given the current emphasis on new pension models in China,it is crucial to explore the role of social capital and its embedded resources in enhancing the utilization of medical services among the elderly population.Objective This study combines theoretical research and empirical analysis to analyze the status quo of medical service utilization among rural empty-nest elderly hypertensive patients aged 60 and above and the influence of different levels of social capital factors on medical service utilization,based on the perspective of social capital,the scientific basis and countermeasures for improving the utilization of medical services for empty-nest elderly hypertensive patients in rural areas were put forward.Methods The data analyzed in this study came from a cross-sectional survey on the quality of life of elderly hypertensive patients conducted in 3 cities with different economic development levels in Shandong Province from June to July 2021.The research objects were selected rural empty-nest elderly hypertensive patients aged 60 and above who participated in the survey completely;through the process of data extraction,sorting,elimination,and merging,835 effective samples were finally included.The variables in this study encompass three main components:patient’s basic characteristics,patient’s social capital information,and patient’s medical service utilization status.The individual-level stock of social capital is measured using the"resource generator" scale,while hierarchical social capital indicators,such as social trust,reciprocity,and mutual assistance,are utilized to assess the patient’s social capital.In this study,the basic personal characteristics,social capital status and medical service utilization status of the sample population were described in general statistics.Univariate and multivariate analysis methods were used to analyze the influencing factors of whether the elderly used medical services at the individual level;a two-level Logit regression model was used to analyze the medical service utilization behavior of the elderly over 60 years old.Analysis,the above analysis was mainly carried out by STATA 16.0 software.Results(1)The individual-level social capital score is reported as(18.66±4.13),indicating an upper-middle level.Among the dimensions,domestic resource has the highest score,followed by problem-solving resources with difficulties.Expert consultation resources rank second,while personal skill resources have the lowest score.In terms of village-level social capital,54.61%of patients had high village-level trust,and 53.89%of patients had high village-level reciprocity.(2)Regarding medical service utilization,among the 835 rural empty-nest elderly hypertensive patients,390 individuals(46.71%)utilized outpatient services in the past year,while 139 individuals(16.65%)had inpatient service utilization during the same period;a total of 78 patients failed to see a doctor when they should see a doctor,accounting for 9.34%;there were 23 patients who should be hospitalized but were not hospitalized,accounting for 2.63%.(3)The results of univariate analysis showed that patients with medical insurance,medical decisions made by their spouses and others,chronic disease comorbidities,high blood pressure measurement frequency,poor self-rated health status,and few domestic resources used more outpatient services(P<0.05);patients have medical insurance,have minimum living security,do not go out every day,have difficulty going out,the time to the nearest medical institution is 6 minutes or more,the source of funds for medical treatment is children’s savings or other sources,have chronic diseases and comorbidities,self-assessed poor health,and life satisfaction Patients with poor medical degree,low individual total social capital,and few domestic resources utilized more inpatient services(P<0.05);patients whose self-rated economic status is not moderate,poor relationship with children,normal BMI,poor life satisfaction,less individual-level social capital,less domestic resource,few expert consultation resources,and less problem-solving resources are more likely to fail to seek medical attention.Seeing a doctor(P<0.05);Patients who are female,have minimum living allowances,take less than 10 minutes to the nearest medical institution,have blood pressure measurements every half a month,have less individual-level social capital,have few domestic resources,have few expert consultation resources,and have few problem-solving resources are more likely to develop Should be hospitalized but not hospitalized(P<0.05).(4)After controlling the confounding factors,the two-level Logit regression model showed that expert advice resources(OR=1.192,P=0.005)had a positive impact on the outpatient service utilization of empty-nest elderly hypertensive patients in the sample area.The domestic resource(OR=0.870,P=0.006)have a negative impact on the utilization of outpatient services;village-level reciprocity(OR=0.502,P=0.030)had a positive impact on patients’ inpatient service utilization,individuallevel social capital(OR=0.91,P=0.024),domestic resource(OR=0.820,P=0.003),village-level trust(OR=0.601,P=0.026).The higher the individual-level social capital(OR=0.936,P=0.014)and expert advice resources(OR=0.799,P=0.015),the lower the possibility of patients failing to seek medical treatment.Conclusion and Suggestion The results of this study show that the social capital status of rural empty-nest elderly hypertensive patients in the sample area is generally above the middle level;the level of utilization of medical services is not high,and there are relatively few cases of non-hospitalization and non-hospitalization.After controlling confounding factors,domestic resource positively affect the utilization of outpatient services and inpatient services,expert advice resources are positively affecting the utilization of outpatient services,and the should but not see a doctor,Individuals with higher overall social capital have a lower probability of seeking medical care without actually visiting a healthcare provider or utilizing hospital services,higher levels of trust within villages are associated with a lower probability of utilizing hospital services,conversely,higher levels of reciprocity within villages are associated with a higher probability of utilizing hospital services.Based on the findings,this study puts forward the following suggestions:(1)Guide rural empty-nest elderly hypertensive patients to develop a rational understanding of social capital.Grassroots healthcare institutions can carry out promotional education to highlight the key dimensions of social capital,ensuring that patients can receive targeted assistance and have their medical needs met when they require medical services.(2)Enhance expert advice resources for rural empty-nest elderly hypertensive patients to improve their utilization of medical services.This can be achieved by establishing a robust expert consultation network and providing training and support for professional consultation services.Patients should have convenient access to professional medical advice and recommendations,and healthcare providers should undergo regular training and exchange programs.(3)Enrich the social capital of rural empty-nest elderly hypertensive patients at multiple levels.Public opinion should encourage patients to maintain their social networks and enrich individual-level social capital while actively engaging in reciprocal cooperation and mutual assistance with villagers.This will foster mutual support and resource sharing among patients and between patients and villagers. |
PDF Full Text Request