| In the background of the accelerated development of aging in China,the majority of the elderly groups generally have a high proportion of sicken.Early illness and long illness after entering old age,the health status and the quality of life in the later age are poor.In the face of this urgent problem,community-based geriatric medical care service,as one of the most important basic contents in the construction of China’s new pension support and security system,has become the core and focus of the current government support and development because it conforms to the stage characteristics and pension cultural tradition of China’s economic and social development.In this situation,whether the convenience and accessibility of medical care services has an exact effect on improving the health level and life satisfaction of the elderly,and the influence mechanism among them have gradually become the focus of academic circles.In this study,the elderly over 60 years old living in Shijiazhuang urban area are taken as the research objects.First of all,according to literature research and theoretical research,it is determined that the expanded Andersen model and the relevant definitions of the World Health Organization(WHO)are the theoretical basis to define the connotation and dimensions of accessibility of community medical care services.And further use the Hierarchy of Needs Theory and Multiple Welfare Theory to build a theoretical framework,and build a mediation effect model of the influence mechanism between the accessibility of community medical care services,elderly self-assessment health and elderly life satisfaction.On this basis,the self-designed questionnaire was used to conduct in-depth interviews in the communities to collect data which is needed for research.The descriptive statistics and correlation analysis were carried out with SPSS 25 software,and the mediation effect of the model was tested by three-step method and Bootstrap method respectively.The regression analysis results of three-step method show that: In the intermediary effect model,both the accessibility of community medical care services and the elderly’s self rated health have a positive impact on life satisfaction(B=0.129,P<0.001)(B=1.987,P<0.001).Compared with the direct effect model(B=0.209,P<0.001),it was found that self rated health had a positive partial mediating effect in the model.Bootstrap analysis shows that: Self rated health also has a positive mediating role in the mechanism of the impact of accessibility to community medical care services on life satisfaction of the elderly(B=0.4638,95% CI[0.2822,0.6453]).The total effect of the model is 0.1764(95% CI[0.0762,0.3695]),the direct effect is 0.1692(95% CI[0.1434,0.2817]),and the indirect effect is 0.0072(95% CI[0.0044,0.1617]).This conclusion is consistent with the three-step method.The comprehensive use of two intermediary effect test methods ensures that the conclusions obtained have high accuracy and reliability.According to the above conclusions,this study proposed four basic measures to improve the elderly’s life satisfaction from three aspects: improving the space-time accessibility and affordability of community medical care services,and focusing on the impact of health on the elderly’s life satisfaction.A)Optimize the spatial layout of urban medical care services,and enhance the elderly’s perception of relevant services around them;B)Rationalize the price of medical care services for the elderly;C)Improve the income distribution system for the elderly and narrow the income gap between retirees in different industries;And D)Implement community medical care services for the elderly and further develop new forms of community-based elderly care and health security. |
