Department of Applied Health Sciences, School of Public Health, Indiana University, Bloomington, Indiana.
Center for General Education, National Tsing Hua University, Hsinchu City, Taiwan.
Int J Health Plann Manage. 2019 Apr;34(2):e1135-e1148. doi: 10.1002/hpm.2749. Epub 2019 Feb 21.
It is unclear if older adults' preventive health care utilization is associated with better health in China, as the elderly population and prevalence of chronic disease have escalated.
Applying the Donabedian's model for evaluating quality of health care, we analyzed data from the 2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey with 5304 older adults 65 years old and above. The study used propensity score matching to decrease selection bias on preventive care utilization. Preventive care utilization was defined as the use of annual physical examination at least once a year among older adults. Three ordered logistic regression models were performed to evaluate preventive care utilization and three health-related measurements of current health status, overall health status improvement in the past 12 months, and life satisfaction, controlling for socioeconomic, demographic, and biological factors.
Older adults who used preventive care reported better health status, overall health status improvement in the past 12 months, and life satisfaction (adjusted odds ratios [AORs] = 1.24, 1.20, 1.30, respectively; all Ps < 0.01), compared with participants who did not use preventive care.
The research findings suggest that the Chinese central government should continue to enhance the role of preventive care services with further reforms in order to improve older adults' health and life conditions.
随着中国老年人口和慢性病患病率的上升，老年人的预防保健利用情况是否与健康状况的改善相关尚不清楚。
本研究应用 Donabedian 健康保健质量评估模型，分析了来自 2012 年和 2014 年中国纵向健康长寿调查的 5304 名 65 岁及以上老年人的数据。该研究采用倾向评分匹配来减少预防保健利用的选择偏差。将每年至少进行一次年度体检定义为老年人的预防保健利用。采用三个有序逻辑回归模型来评估预防保健利用情况以及当前健康状况、过去 12 个月整体健康状况改善和生活满意度的三个健康相关测量指标，同时控制社会经济、人口统计学和生物学因素。
与未使用预防保健的参与者相比，使用预防保健的老年人报告的健康状况更好，过去 12 个月的整体健康状况改善和生活满意度更高（调整后的优势比 [AOR] 分别为 1.24、1.20、1.30；均 P<0.01）。
研究结果表明，中国中央政府应继续通过进一步改革加强预防保健服务的作用，以改善老年人的健康和生活条件。
