Social Support and Health Services Use in People Aged over 65 Years Migrating within China: A Cross-Sectional Study
Social Support and Health Services Use in People Aged over 65 Years Migrating within China: A Cross-Sectional Study
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中国境内 65 岁以上人口流动的社会支持和健康服务使用情况：一项横断面研究
DOI：
10.3390/ijerph17134651
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发表时间：
2020-07-01
影响因子：
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通讯作者：
Tang, Shangfeng
中科院分区：
文献类型：
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作者：
Long, Chengxu;Wang, Ruoxi;Tang, Shangfeng
背景：由于户籍制度的原因，中国老年流动人口难以获得足够的医疗服务和社会支持。因此，本研究考察了中国境内流动老年人的卫生服务使用、社会支持获取和相互作用。方法：数据来源于2015年中国流动人口动态监测调查，采用概率与规模成比例的抽样策略。采用结构方程模型和中介效应检验来探讨两者之间的关联。结果：约45.9%的老年流动人口在需要时没有寻求医疗服务。门诊和住院服务的使用比免费的基本公共卫生服务更为普遍。卫生服务的使用与迁移时间和后代迁移呈负相关，而与外部社会支持呈正相关。研究发现，外部社会支持分别对卫生服务使用与迁移时间和后代迁移等自变量之间的关系起中介作用。结论：迁移时间较长或为子女迁移的老年移民似乎获得较少的外部社会支持，导致卫生服务的使用减少。外部社会支持是改善中国老年流动人口保健服务均等化的关键措施。
Background: Due to the household registration system, Chinese elderly migrants have insufficient access to health services and social support. Thus, this study examined the use of health services, the access to social support, and the interaction among the elderly migrating within China. Methods: Data were obtained from the China Migrant Dynamic Monitoring Survey in 2015, adopting probability proportionate to size as the sampling strategy. Structural equation modeling and mediating effect tests were employed to explore the associations. Results: Approximately 45.9% of elderly migrants did not seek health services when needed. The use of outpatient and inpatient services was more common than free essential public health services. The use of health services was negatively associated with migrating duration and migrating for offspring, while it was positively associated with outer social support. The mediating effects of outer social support were discovered on the relationships between the use of health services and independent variables such as migrating duration and migrating for offspring, respectively. Conclusion: Elderly migrants with a longer migrating duration or migrated for offspring seem to obtain less outer social support, resulting in a decreased use of health services. Outer social support was suggested as a key effort to improve the equalization of health services in Chinese elderly migrants.