健康老龄化背景下农村老年健康服务的可及性障碍与优化路径研究

Research on the Accessibility Barriers and Optimization Paths of Rural Elderly Health Services under the Background of Healthy Aging

摘要: 随着中国进入快速老龄化社会，在乡村地区出现了“城乡倒置”的现象，“老有余”“弱更多”，即乡村地区老年人数量更多、老龄化水平更高、失能率更高，但医疗资源投入更少。文章以“5A”可及性理论为基础，并综合运用国家卫生统计年鉴、政策文献以及相关研究成果，对农村老年人健康服务从空间距离、价格费用、便利程度、时间花费及认同度等方面存在的困难进行了深入分析。笔者分析其原因在于城乡二元体制下的惯性思维、基层卫生服务功能的弱化乃至消失以及农村社会结构及代际养老模式的变化。为此，文章建议在构建县域医疗共同体的同时，应推动医养康养融合发展，推进长期照护保险试点，完善老年人便利化信息服务，加强老年教育。以期为破解农村老年人健康困境提供一定的理论借鉴及对策建议。

Abstract: As China enters a rapidly aging society, a phenomenon of “urban-rural inversion” has emerged in rural areas, characterized by “more elderly and weaker”, meaning that the number of elderly people, the level of aging, and the rate of disability are higher in rural areas, but the investment in medical resources is lower. Based on the “5A” accessibility theory and by comprehensively applying the National Health Statistics Yearbook, policy documents, and related research results, this article conducts an in-depth analysis of the difficulties faced by rural elderly people in accessing health services in terms of spatial distance, price and cost, convenience, time consumption, and recognition. The author attributes the reasons to the inertial thinking under the urban-rural dual system, the weakening or even disappearance of the functions of primary health services, and the changes in the rural social structure and intergenerational elderly care model. Therefore, the article suggests that while building county-level medical communities, efforts should be made to promote the integrated development of medical care, elderly care, and health care, advance the pilot program of long-term care insurance, improve the information service for the convenience of the elderly, and strengthen elderly education. The aim is to provide certain theoretical references and policy suggestions for solving the health problems of rural elderly people.