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基于户籍差异视角的中国流动老年人预防性医疗服务及影响因素:一项横断面研究

Preventive medical services and influencing factors for migrant elderly in China from the perspective of household registration differences: A cross-sectional study.

作者信息

Zhao Xiaomin, Ding Bairen, Wang Yijie

机构信息

Department of Sociology, Hohai University, Nanjing, China.

出版信息

Medicine (Baltimore). 2025 Mar 14;104(11):e41885. doi: 10.1097/MD.0000000000041885.

Abstract

Preventive medical services are very important to migrant elderly's health. This study takes Chinese migrant elderly as an example, aiming to analyze their preventive medical services, and further explore the differences and influencing factors of preventive medical services for rural-urban migrant elderly and urban-urban migrant elderly, so as to provide experience for optimizing the health-care policies for them. A total of 5842 migrant elderly aged 60 and above from China Migrants Dynamic Survey 2017 were selected. Information on preventive medical services was acquired by the self-report questionnaire. Contingency table analysis was employed to describe migrant elderly's preventive medical services. Binary logit regression model and Fairlie decomposition method were employed to examine factors affecting preventive medical services for migrant elderly and their household registration differences. Preventive medical services for migrant elderly, which measured by the establishment of community residents' health records, accounted for 32.64%. However, the proportion of rural-urban migrant elderly was 6.29% lower than that of urban-urban migrant elderly. Based on the analytical framework of Anderson model, the protective factors affecting preventive medical services for migrant elderly were gender, age, and local network among predisposing factors, social security participation and coverage of health education among enabling factors, and health professional assessment among need factors, while the risk factor was household income among enabling factors. Moreover, they explain the household registration differences in preventive medical services for migrant elderly at 52.46%, with the enabling factors (especially social security participation) contributing the most. Therefore, Preventive medical services for migrant elderly are not very good, and there are significant differences in household registration. Relevant government departments should implement urban-inclusive policies and improve the social support system of preventive medical services for migrant elderly, while providing focused care and assistance to rural-urban migrant elderly.

摘要

预防性医疗服务对老年流动人口的健康非常重要。本研究以中国老年流动人口为例,旨在分析他们的预防性医疗服务情况,并进一步探究城乡流动老年人口和城城流动老年人口预防性医疗服务的差异及影响因素,以便为优化针对他们的医疗保健政策提供经验。研究选取了2017年中国流动人口动态监测调查中5842名60岁及以上的老年流动人口。通过自填问卷获取预防性医疗服务的相关信息。采用列联表分析描述老年流动人口的预防性医疗服务情况。运用二元logit回归模型和Fairlie分解法考察影响老年流动人口预防性医疗服务的因素及其户籍差异。以建立社区居民健康档案衡量的老年流动人口预防性医疗服务占比为32.64%。然而,城乡流动老年人口的这一比例比城城流动老年人口低6.29%。基于安德森模型的分析框架,影响老年流动人口预防性医疗服务的保护因素在易患因素中有性别、年龄和本地社会关系网络,在促成因素中有社会保障参与和健康教育覆盖情况,在需求因素中有健康专业评估;而促成因素中的风险因素是家庭收入。此外,它们解释了老年流动人口预防性医疗服务户籍差异的52.46%,其中促成因素(尤其是社会保障参与)贡献最大。因此,老年流动人口的预防性医疗服务情况不太理想,且存在显著的户籍差异。相关政府部门应实施城市包容性政策,完善老年流动人口预防性医疗服务的社会支持体系,同时对城乡流动老年人口提供重点关怀和帮扶。

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