College of Population Studies, Chulalongkorn University, Thailand.
College of Population Studies, Chulalongkorn University, Thailand.
Arch Gerontol Geriatr. 2019 Mar-Apr;81:201-208. doi: 10.1016/j.archger.2018.12.011. Epub 2018 Dec 24.
This study examined rural-urban differences in health visits among older Thais utilizing Andersen's model. Data were drawn from the 2011 Survey of Older Persons in Thailand of adults 50 years and older (N = 56,435). Logistic regression models examine individuals' predisposing, enabling, and health need factors for explaining older adults' health care use. Approximately 50% of older adults sought health care but urban dwellers were more likely than rural dwellers to seek health care (54.8% vs. 49.7%). Predisposing factors and health needs narrow the rural-urban gap while enabling factors widened the gap in health visits. The receipt of financial support from children presented a significant moderating effect in the rural-urban divide of health care use. Despite Thailand's universal access to health care, geographic inequity in health care utilization withstands. Findings suggest investments in education, income security, social participation, and healthy lifestyle promotion can improve health care utilization. Furthermore, results suggest a need for continued investigation of the role of family support in bridging the rural-urban divide in the health of older Thais.
本研究利用安德森模型考察了泰国老年人的城乡健康访问差异。数据来自 2011 年泰国老年人调查,涵盖 50 岁及以上的成年人(N=56435)。逻辑回归模型检验了个体的倾向因素、促成因素和健康需求因素,以解释老年人的医疗保健使用情况。约有 50%的老年人寻求医疗保健,但城市居民比农村居民更有可能寻求医疗保健(54.8%比 49.7%)。倾向因素和健康需求缩小了城乡差距,而促成因素则扩大了健康访问的差距。从子女那里获得经济支持对医疗保健使用的城乡差距有显著的调节作用。尽管泰国实现了医疗保健的普及,但医疗保健利用方面的地域不平等仍然存在。研究结果表明,投资于教育、收入保障、社会参与和促进健康的生活方式可以改善医疗保健的利用。此外,研究结果表明,需要继续调查家庭支持在弥合泰国老年人城乡健康差距方面的作用。