SSM | 精准扶贫政策对老年人医疗保健利用的影响——来自中国的准实验分析

文摘   2024-10-10 14:19   北京  

Citation: Wang, X., & Ye, X. (2024). Impact of the targeted poverty alleviation policy on older adults’ healthcare utilization: A quasi-experimental analysis from China. Social Science & Medicine, 356, 117146.

DOI: https://doi.org/10.1016/j.socscimed.2024.117146


中国政府于 2015 年实施了精准扶贫 (Targeted Poverty Alleviation, TPA) 政策以消除贫困。为了评估 TPA 政策的健康绩效,本文研究了 TPA 政策对通常更易受贫困和疾病影响的老年人的医疗保健利用的影响。

我们利用中国健康与养老纵向研究 (CHARLS) 的四波(2011,2013,2015和2018) 数据,使用双重差分 (DID) 方法调查了TPA 政策对老年人门诊和住院利用率的影响。总共有 5285 名老年受访者被纳入最终样本。

结果表明,TPA 政策的实施对提高贫困老年人的住院护理利用率产生了显著的积极影响,而它对门诊服务利用率的影响并不显著。为了确保住院护理利用率水平的提高不是由健康状况恶化引起的,我们进一步分析了 TPA 政策对贫困老年人健康结果的影响。结果表明,TPA 政策可以通过增加住院就诊和住院支出来改善贫困老年人的自评健康状况并减少 ADL (日常生活活动)限制的数量。异质性分析发现,在TPA政策的持续干预下,登记贫困家庭中女性、已婚和年龄在70岁及以上的老年人住院护理使用率较高。

中国的 TPA 政策改善了经济上处于不利地位的老年人的医疗保健机会,并有助于改善他们的健康状况。这一证据可能对其他旨在减少贫困和实现卫生公平的低收入和中等收入国家产生广泛影响。

Abstract

China implemented the Targeted Poverty Alleviation (TPA) policy in 2015 to fight against poverty. In order to assess the health performance of the TPA policy, this study aims to evaluate the impact of the TPA policy on healthcare utilization among older adults who normally have higher vulnerability to poverty and diseases. Drawing on data from four waves of the China Health and Retirement Longitudinal Study (CHARLS), we investigated the impact of the TPA policy on older individuals' outpatient and inpatient utilization using the difference-in-differences (DID) approach. In total, 5285 older respondents were incorporated into a final sample. The results indicated that the implementation of the TPA policy had a significantly positive impact on increasing inpatient care utilization for poor older adults. However, its impact on outpatient service utilization was not significant. To ensure that the increased level of inpatient care utilization was not caused by deteriorating health status, we further analyzed the impact of the TPA policy on poor older adults’ health outcomes. Results indicated that the TPA policy improved self-rated health and reduced the number of ADL limitations among older adults in registered poor households. The positive impact of the TPA policy on inpatient care utilization was found to be most beneficial for older adults in poor households who were female, coupled, and aged 70 years and above. The TPA policy in China improved healthcare access for economically disadvantaged older adults and contributed to the enhancement of their health outcomes. This evidence may have broad implications for other low- and middle-income countries aiming to reduce poverty and achieve health equity.

编辑:Qian Liu

Health Econ Lab
记录卫生领域的前沿学术作品。
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