社会经济剥夺、医疗服务可及性与中国老年成年人收入相关的健康不平等：来自 2011 年至 2018 年全国纵向调查的证据。

Socioeconomic deprivation, medical services accessibility, and income-related health inequality among older Chinese adults: evidence from a national longitudinal survey from 2011 to 2018.

机构信息

Research Institute of Public Health and Social Security, School of Public Administration, Hunan University, Changsha, China.

School of Political Science and Public Administration, China University of Political Science and Law, Beijing, China.

出版信息

Fam Pract. 2023 Dec 22;40(5-6):671-681. doi: 10.1093/fampra/cmad018.

DOI:10.1093/fampra/cmad018

PMID:36928561

Abstract

BACKGROUND

Health inequality poses a challenge to improving the quality of life of older adults as well as the service system. The literature rarely explores the moderating role of medical services accessibility in the association between socioeconomic deprivation and health inequality.

OBJECTIVE

This study examines the socioeconomic deprivation and medical services accessibility associated with health inequality among older Chinese adults, which will contribute to the medical policy reform.

METHODS

Using data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyse 14,232 older adults. This paper uses a concentration index (CI) to measure the income-related health inequality among the target population and employs a recentered influence function-concentration index-ordinary least squares (RIF-CI-OLS) model to empirically analyse the correlation between socioeconomic deprivation and health inequality among older Chinese adults. Based on the correlation analysis, we discuss the moderating effect of medical services accessibility.

RESULTS

We find that health inequality exists among older Chinese adults and that the relative deprivation in socioeconomic status (SES) is significantly associated with health inequality (β∈ [0.1109, 0.1909], P < 0.01). The correlation between socioeconomic deprivation and health inequality is moderated by medical services accessibility, which means that an increase in medical services accessibility can weaken the correlation between socioeconomic deprivation and health inequality.

CONCLUSION

China needs an in-depth reform of its medical services accessibility system to promote the equitable distribution of medical services resources, strengthen medical costs and quality management, and ultimately mitigate the SES reason for health inequality among older Chinese adults.

摘要

背景

健康不平等对提高老年人的生活质量和服务体系构成挑战。文献很少探讨医疗服务可及性在社会经济剥夺与健康不平等之间的调节作用。

目的

本研究考察了社会经济剥夺和医疗服务可及性与中国老年人群健康不平等之间的关系，这将有助于医疗政策改革。

方法

利用中国老年健康长寿跟踪调查（CLHLS）2011、2014 和 2018 年的数据，我们分析了 14232 名老年人。本文使用集中指数（CI）衡量目标人群中与收入相关的健康不平等，并使用最近中心化影响函数-集中指数-普通最小二乘法（RIF-CI-OLS）模型对中国老年人群中社会经济剥夺与健康不平等之间的相关性进行实证分析。基于相关性分析，我们讨论了医疗服务可及性的调节作用。