供需双重视角下老年人居家社区医养服务利用的影响因素测度研究

Research on Measuring the Influencing Factors of Elderly People’s Utilization of Home-Based Community Medical and Elderly Care Services from Both Supply and Demand Perspectives

摘要: 随着全球人口老龄化趋势的加剧，如何有效应对老年人口增长带来的健康与养老服务需求，成为社会各界广泛关注的重大课题。医养结合模式，作为一种将医疗资源与养老服务深度融合的创新服务模式，旨在为老年人提供更加全面、连续、便捷的健康照护与生活支持。在这一背景下，居家社区养老服务作为实现老年人“老有所养、老有所医”目标的重要途径，其需求特征、影响因素及优化策略的研究显得尤为重要。本研究聚焦于医养结合视域下的居家社区养老服务，其中，本文医养结合内涵主要针对失能、半失能及慢性病老人的整合照护服务，旨在通过科学的量化方法，探讨影响老年人对居家社区养老服务需求的多维度因素，包括但不限于个人健康状况、经济能力、家庭支持、社会环境、政策导向等。通过实证分析，研究发现，IADL受损和慢性病显著提升了服务需求，揭示了医疗与养老融合需求的特殊规律。值得注意的是，受教育程度对社区养老服务利用呈现显著负向影响，揭示了当前服务供给与高知群体需求的错位。研究结果验证了医养结合背景下特殊需求规律的存在，为完善养老服务供给体系提供了重要政策启示。

Abstract: With the intensifying trend of global population aging, effectively addressing the health and elderly care service demands arising from the growing elderly population has become a critical issue of widespread concern. The Medical-Nursing Combination model, as an innovative service mode deeply integrating medical resources with elderly care services, aims to provide comprehensive, continuous, and convenient health care and life support for the elderly. Against this backdrop, research on the demand characteristics, influencing factors, and optimization strategies of home and community-based elderly care services is particularly crucial for realizing the goal of “providing for the aged and ensuring their health.” This study focuses on home and community-based elderly care services from the perspective of Medical-Nursing Combination. In this context, the connotation of Medical-Nursing Combination primarily targets integrated care services for disabled, semi-disabled, and chronically ill older adults. Through scientific quantitative methods, this paper explores the multi-dimensional factors influencing the demand for these services, including but not limited to individual health status, economic capacity, family support, social environment, and policy orientation. Empirical analysis reveals that impaired Instrumental Activities of Daily Living (IADL) and chronic diseases significantly increase the demand for services, uncovering specific patterns in the integration of medical and nursing needs. Notably, education level demonstrates a significant negative impact on the utilization of community elderly care services, highlighting a mismatch between current service supply and the needs of highly educated groups. These findings verify the existence of specific demand patterns under the Medical-Nursing Combination background and provide important policy implications for improving the elderly care service supply system.