医养结合与老年健康管理服务利用——来自医养结合试点城市的经验证据

The Integration of Medical and Elderly Care and Utilization of Elderly Health Management Services: Empirical Evidence from Pilot Cities of Integrated Medical and Elderly Care

《财经研究》2023年49卷第12期 页码：121-135 online：2023年12月3日

作者

中：陈岩 , 杨翠迎

英：Chen Yan, Yang Cuiying

作者单位：上海财经大学 公共经济与管理学院，上海 200433

摘要及关键词

摘要：医养结合是实现健康中国和积极老龄化战略的重要手段，也是养老服务体系高质量发展的必要条件。文章利用微观数据，运用双重差分法实证检验了医养结合政策试点对老年健康管理服务利用的影响。研究发现，医养结合政策试点显著促进了老年健康体检服务、健康评估和干预服务的利用以及健康档案的建立，提升了老年健康管理服务利用水平，但这种影响因城市地理区位、行政等级及老龄化水平的不同而呈现差异化的效果。进一步分析表明，医养结合政策试点通过政策集聚效应、增加政府资金投入、推动设施临近设置和拓展服务方式等机制对老年人相关健康管理服务的利用产生显著影响。文章研究认为，我国目前医养结合发展正处于由国家试点向示范项目引领和全国推广的关键阶段，应充分发挥医养结合政策试点的政策效应与示范项目的引领作用；加强医养结合政策对不同经济发展水平、不同行政等级或不同老龄化水平城市的适配性，避免政策的“一刀切”；要重视社区医养结合设施的建设和功能布局；优化服务方式，化被动为主动，积极提升健康管理的有效性。

关键词：医养结合试点；老年健康管理；服务利用；人口老龄化

Summary: The integration of medical and elderly care is an important means to realize the strategy of healthy China and active aging, and it is also a necessary condition for the high-quality development of the social elderly care service system. Based on the data of CHARLS, this paper systematically evaluates the impact of the pilot of integrated medical and elderly care policy on the utilization of elderly health management services by using a DID model. It is found that this policy significantly promotes the utilization of elderly health examination services, health assessment and intervention services, and the establishment of health records, and improves the utilization level of elderly health management services, but this impact shows different effects depending on the geographical location, administrative level, and aging level of the city. Further analysis shows that this policy has a significant impact on the utilization of health management services for the elderly through mechanisms such as policy agglomeration effect, increased government capital investment, promotion of facility proximity, and expansion of service methods. The study believes that the development of integrated medical and elderly care in China is currently in a critical stage of leading from national pilot projects to demonstration projects and promoting them nationwide. The policy effect of pilot projects and the leading role of demonstration projects should be fully exerted. The adaptability of integrated medical and elderly care policy to cities with different economic development levels, administrative levels, or aging levels should be strengthened to avoid the “one-size-fits-all” policy; the construction and functional layout of community medical and elderly facilities should be attached importance to; and service methods should be optimized to turn passivity into proactivity and actively improve the effectiveness of health management. The marginal contributions of this paper are as follows: First, it sorts out in detail the connotation of elderly health management from the perspective of integrated medical and elderly care, and discusses the relationship between the integration of medical and elderly care and the utilization of elderly health management services. Second, it empirically tests the impact of the pilot of integrated medical and elderly care policy on the utilization of elderly health management services, and evaluates its policy effect. Third, it discusses the influence mechanism of the integration of medical and elderly care on the utilization of elderly health management services, providing a theoretical basis for the improvement of follow-up policies and elderly health management services.

Key words:pilot of integrated medical and elderly care; elderly health management; service utilization; population aging

其他信息

DOI：10.16538/j.cnki.jfe.20231016.401

收稿日期：2023-08-04

基金项目：国家社会科学基金重大项目（20&ZD114）；中央高校基本科研业务费专项资金资助（CXJJ-2023-355）

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