不平等护理：中国公共医疗保险对老年人护理服务的影响
Unequal nursing: the impact of China's public health insurance on nursing services for older adults.
作者信息
Zhang Pengfei, Gao Jinghua
机构信息
School of Management, Minzu University of China, Beijing, 100081, China.
College of Humanities and Development Studies, China Agricultural University, Beijing, 100107, China.
出版信息
BMC Nurs. 2025 Jul 1;24(1):803. doi: 10.1186/s12912-025-03459-1.
BACKGROUND
This study examines the relationship between public health insurance and inequality in nursing services for older adults and explores the different impacts of different public health insurance systems in China.
METHODS
Using data from the China Health and Retirement Longitudinal Study, a logistic regression model was used to examine the use of nursing services by people aged 60 years and above.
RESULTS
The results show that participation in public health insurance can significantly improve the chances of older adults accessing nursing services, with participants being 53.57% more likely than nonparticipants to use nursing services. In addition, older adults enrolled in the Urban Employee Basic Medical Insurance program were 26.49% more likely than those enrolled in the Urban‒Rural Resident Basic Medical Insurance program to utilize nursing services, underscoring the substantial inequalities resulting from the structural differences within the public health insurance system.
CONCLUSIONS
Although public health insurance plays a key role in improving the accessibility of nursing services for older adults, it also exacerbates existing inequalities. China's health security reform should improve access to nursing services by increasing participation in public health insurance and eliminating discrimination based on status within the insurance framework.
背景
本研究考察了公共医疗保险与老年人护理服务不平等之间的关系，并探讨了中国不同公共医疗保险制度的不同影响。
方法
利用中国健康与养老追踪调查的数据，采用逻辑回归模型研究60岁及以上人群对护理服务的使用情况。
结果
结果显示，参加公共医疗保险可显著提高老年人获得护理服务的机会，参保者使用护理服务的可能性比未参保者高53.57%。此外，参加城镇职工基本医疗保险的老年人使用护理服务的可能性比参加城乡居民基本医疗保险的老年人高26.49%，这凸显了公共医疗保险体系内部结构差异导致的巨大不平等。
结论
尽管公共医疗保险在提高老年人获得护理服务的可及性方面发挥了关键作用，但它也加剧了现有的不平等。中国的医保改革应通过增加公共医疗保险的参保率并消除保险框架内基于身份的歧视来改善护理服务的可及性。
Zotero 插件