Analysis Of The Effect Of Health Service Utilization On The Health Status Of The Elderly In China

Objective: With the accelerating process of population aging in China,the size of the elderly group is expanding,and at the same time,as the physical functions of the elderly will continue to degenerate,their health level will gradually decline,which will make them an important subject of medical service utilization.This study aims to provide a realistic reference for improving the health level of the elderly and improving the medical service system by studying the direction and size of the path of the influence of medical service utilization on the health status of the elderly.Methods: This study used the 2018 China Health and Aging Tracking Survey(CHARLS)project database to understand the health status and medical service utilization of the elderly through group descriptions;using a binary logit regression model,we empirically analyzed the pathways of the utilization of outpatient and inpatient services on the health level of the elderly.The pathways of influence of outpatient and inpatient service utilization on the health level of the elderly were empirically analyzed using a binary logit regression model,and the reasons for the differences in the impact of medical service utilization on the health of the elderly were explored through variance analysis.Results:(1)Combining the three aspects of physiological,psychological and social participation,it can be found that the overall health level of the elderly is average.In terms of physiological health,the number of older adults with impaired ADL and IADL function was 29.95% and 78.88%.In terms of mental health,the percentage of older adults with CES-D score results of depression was45.6%.In terms of social participation,the percentage of seniors who participated in social interaction was 49.82%.(2)The statistical description of the current situation of medical service utilization reveals that the utilization rate of outpatient services for the elderly in China is 18.92% and the utilization rate of inpatient services is 23.9%,and the overall utilization level of medical services needs to be improved.(3)By constructing different regression models,it was found that the utilization of outpatient services had a positive effect on the physical health,psychological health and social participation of the elderly in China,and all of them were significant at the 1% level,and the marginal effects were above 5%.Inpatient services also have a significant positive effect on physiological health and psychological health of the elderly at the 1% level,but the direction of the effect on social participation is negative and not significant.(4)The difference analysis can be concluded that there are gender differences,urban-rural differences and education level differences in the health status of the elderly by medical service utilization,specifically,the impact of medical service utilization on the health status of female elderly is more obvious;the elderly with elementary school education or below have higher level of health risk,and the impact of medical service utilization on the health of rural elderly is more significant level;the rural elderly are more sensitive to the health of the elderly compared to the The sensitivity of medical service utilization was higher among the rural elderly compared to the urban elderly.Conclusion: At present,the overall health level of elderly people in China is average and there are differences in gender,marital status,education level and place of residence;the level of medical service utilization of elderly people is low and there are some differences in gender,age and income level;medical service utilization significantly and positively affects the physical and psychological health status of elderly people and negatively affects the social participation of elderly people,while there are significant differences in gender,place of residence and education level.Medical insurance plays a mediating role in the effect of medical service utilization on the health of the elderly,with an indirect effect value of 30.1%.In the future,efforts should be made to improve the social security system,enhance the capacity of medical services and strengthen health knowledge education to effectively improve the utilization of medical services and the health level of the elderly in China.