目的 了解中国中老年人身体健康状况,分析在三种基本社会医疗保险下卫生服务利用的不平等性.方法 基于中国健康与养老追踪调查2013年数据,采用多元Logistic回归等方法分析拥有不同基本医保的中老年人在身体健康状况和卫生服务利用方面的差异.结果 城镇职工医疗保险、城镇居民医疗保险和新型农村合作医疗保险人员自评健康状况得分分别为2.74分、2.59分和2.49分;慢性病患病率分别为52.07%、55.66%和57.78%;4周患病率分别为12.74%、16.49%和13.92%.相对于城镇职工医疗保险参保人群,新型农村合作医疗参保人群对门诊服务(OR=0.82)和住院服务(OR=0.79)的利用以及城镇居民医疗保险参保人群对门诊服务(OR=0.77)和住院服务(OR=0.69)的利用均处于较低水平;对其中慢性病参保人群进行回归分析其结果相似,以上OR值差异均有统计学意义(P<0.05).结论 不同医保的中老年人在健康状况和卫生服务利用上存在不平等性,应通过统筹发展城乡医保、提高筹资及报销比例来缩小不同医保保障水平的差异.%Objectives To explore health status of the middle-aged and elderly people in China,and analyze wheth-er there exists inequality in health service utilization with different basic social health insurance coverage.Methods Based on 2013 China Health and Retirement Longitudinal Study(CHARLS)data,to examine differences in health status and health service utilization of people with different insurances using multivariate logistic regressions.Results The self-reported health status scores of Urban Employee Basic Medical Insurance(UEBMI),Urban Resident Bas-ic Medical Insurance(URBMI)and Rural New Cooperative Medical System(NCMS)were 2.74、2.59 and 2.49 re-spectively.Chronic diseases prevalence rates were 52.07%、55.66% and 57.78%.,and two-week disease prevalence rates were 12.74%、16.49% and 13.92%.The multivariate logistic regressions showed that using people with UEB-MI as the conference group,people with NCMS used less outpatient services(OR=0.82)and inpatient services(OR=0.79),people with URBMI used less outpatient services(OR=0.77)and inpatient services(OR=0.69)as well.The multivariate logistic regressions of people with chronic disease showed the similar results.Conclusions There exists inequality in health status and health service utilization of different basic social health insurance.China needs to nar-row these health disparities among people with different basic social health insurances by integrating urban-rural health insurance systems,raising health financing,and increasing reimbursements.
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