The Utilization and Influencing Factors of Health Services for Middle Aged and Elderly Chronic Disease Patients
摘要
Background Middle aged and elderly people are at high risk of chronic diseases, and chronic diseases pose challenges to healthcare services for them. Exploring the influencing factors of healthcare service utilization for middle-aged and elderly patients with chronic diseases is of great significance. Objective Analyze the utilization of health services among middle-aged and elderly patients with chronic diseases and its influencing factors, providing a basis for improving the level of health service utilization. Methods Selected 5 280 samples aged ≥45 with chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) 2020 database. Drawing on the Anderson Health Service Utilization Behavior Model, the study variables include: (1) propensity factors, including demographic characteristics such as age, gender, place of residence, marital status, smoking, alcohol consumption, social structure, and health behavior. (2) Enabling factors include the ability to access healthcare services, such as economic living standards (personal annual income), medical insurance, and delayed or cancelled medical services due to the impact of the pandemic. This study ranked individual annual income in descending order and divided it into three equal parts on average. The first third was the low-income group, the middle third was the middle-income group, and the last third was the high-income group. (3) Demand factors, including activities for daily living (ADL) status, self-rated health status, life satisfaction, number of chronic diseases, and personal cognition and evaluation. Dependent variable: health service utilization (outpatient/inpatient service utilization). Using multiple Logistic regression model to analyze the influencing factors of health service utilization among middle-aged and elderly patients with chronic diseases in China. Results Among 5 280 chronic disease patients, 1 487 (28.16%) had outpatient visits in the past month, and 1 393 (26.38%) had inp