Xu Lei, Wang Jia, Xue Caixiu, Yang Ke, Xie Xiaohui, Zhou Wansha, Wang Lianhong
Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Nursing College, Zunyi Medical University, Zunyi, Guizhou, China.
BMC Geriatr. 2025 Jul 2;25(1):439. doi: 10.1186/s12877-025-06108-z.
Accelerated population aging and the growing prevalence of various geriatric diseases in China have placed older adults in a vulnerable position regarding access to health services, including medical care and health checkup services. This study aimed to investigate the use of health services by older adults and its influencing factors.
A total of 9401 respondents aged 60 years and older from the 2020 wave (wave 5) of the China Health and Retirement Longitudinal Study (CHARLS) were included. Employing the Behavioral Model of Health Service Use as a framework, the study categorized the determinants of health service utilization among the elderly into three distinct segments: predisposing factors, enabling factors, and needs-based factors. Multiple logistic regression was used to examine three factors affecting the use of medical care services.
The rate of utilization of health services (including medical care and health checkup services) among older adults was 33.34%. The utilization rates of outpatient visits, hospitalization care, and health checkup services were 21.5%, 23.2%, and 55.30%, respectively. Factors influencing the use of health services varied by different service types. Needs-based factors, including chronic diseases and self-perceived health status, played an essential role in medical care services. Predisposing factors (age, gender, personal income), enabling factors (medical insurance, social insurance), and needs factors (chronic diseases, ADL) will all significantly health service utilization among older adults.
The overall level of health service utilization among older adults is low, so policies and decision-makers can consider improving the development of targeted measures for different service types to increase the utilization rate of medical care services for the elderly and promote the health equity of vulnerable groups.
中国人口老龄化加速以及各类老年疾病患病率不断上升，使老年人在获得包括医疗保健和健康检查服务在内的卫生服务方面处于弱势地位。本研究旨在调查老年人卫生服务的使用情况及其影响因素。
纳入中国健康与养老追踪调查（CHARLS）2020年第5轮调查中9401名60岁及以上的受访者。本研究以卫生服务利用行为模型为框架，将老年人卫生服务利用的决定因素分为三个不同部分： predisposing因素、促成因素和基于需求的因素。采用多元逻辑回归分析影响医疗服务利用的三个因素。
老年人卫生服务（包括医疗保健和健康检查服务）利用率为33.34%。门诊就诊、住院护理和健康检查服务的利用率分别为21.5%、23.2%和55.30%。影响卫生服务利用的因素因服务类型而异。基于需求的因素，包括慢性病和自我感知健康状况，在医疗服务中起着至关重要的作用。Predisposing因素（年龄、性别、个人收入）、促成因素（医疗保险、社会保险）和需求因素（慢性病、日常生活活动能力）均会显著影响老年人的卫生服务利用情况。
老年人卫生服务利用总体水平较低，政策制定者可考虑针对不同服务类型制定改进措施，以提高老年人医疗服务利用率，促进弱势群体的健康公平。
