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Effect of Intergenerational Support from Children on Older Adults' Healthcare Seeking Behaviors
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摘要:
目的 探究子女代际支持对老年人就医行为的影响，为促进老年人合理就医提供建议。 方法 使用中国家庭追踪调查（China Family Panel Studies, CFPS）2016年基线数据与2018年全国追踪数据，选择60岁及以上、有健在子女的居民5690人。使用logistic回归分析子女代际支持对老年人就医行为的影响。 结果 子女提供经济支持的老年人两周就诊的概率相对较高（OR=1.129，95%CI：1.004～1.271，P<0.05），但子女是否提供经济支持对于老年人过去一年住院服务利用的影响不显著（P>0.05）。子女提供日常照料支持对老年人两周就诊和过去一年住院服务利用均有促进作用（OR=1.155，95%CI：1.021～1.307，P<0.05；OR=1.204，95%CI：1.053～1.378，P<0.05）。是否每天与子女见面对于老年人两周就诊、过去一年是否住院的影响均不显著（P>0.05）。 结论 子女代际支持对老年人就医行为有着重要的影响。应发挥子女代际支持的优势作用，同时完善正式社会支持渠道以缓解子女代际支持压力，为促进老年人合理就医提供建议，以进一步提高老年人整体健康水平。 Abstract:Objective To investigate the impact of intergenerational support from children on older adults' healthcare seeking behaviors and to provide suggestions to help promote sensible healthcare seeking behaviors in older adults. Methods Based on the data from the 2016 baseline data and the 2018 national tracking survey of China Family Panel Studies (CFPS), a total of 5690 respondents aged 60 years and older with surviving children were selected for the study. Logistic regression was used to analyze the effect of children's intergenerational support on older adults' healthcare seeking behavior. Results The probability of seeing a doctor in the last two weeks was relatively higher among older adults whose children provided financial support (odds ratio [OR]=1.129, 95% confidence interval [CI]: 1.004-1.271, P<0.05), but the effect of whether children provided financial support on one-year hospitalization was not significant (P>0.05). Daily care support from children contributed positively to both seeing a doctor in the last two weeks and one-year hospitalization among older adults (OR=1.155, 95% CI: 1.021-1.307, P<0.05; OR=1.204, 95% CI: 1.053-1.378, P<0.01), while whether or not older adults saw their children daily had no significant effect on either seeing a doctor in the last two weeks or one-year hospitalization among older adults (P>0.05). Conclusion Intergenerational support from children has an important influence on the healthcare seeking behaviors of older adults. The advantageous role of children's intergenerational support should be made full use of. In addition, formal channels of social support should be improved to alleviate the pressure on children to provide intergenerational support and suggestions should be provided to promote sensible healthcare seeking behaviors in older adults, so as to further improve the overall health level of older adults. -
Key words:
- Intergenerational support /
- Healthcare seeking behavior /
- Older adults
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表 1 老年人就医情况影响因素的单因素分析（n=5690）
Table 1. Univariate analysis of influencing factors of healthcare seeking behaviors in older adults (n=5690)
Variable Seeing a doctor in the last
two weeks/case (%)χ2 P One-year hospitalization/case (%) χ2 P Yes No Yes No Financial support from children 24.845 <0.001 3.965 0.046 No 907 (44.1) 1849 (50.9) 631 (46.1) 2125 (49.2) Yes 1152 (55.9) 1782 (49.1) 738 (53.9) 2196 (50.8) Daily care support from children 27.465 <0.001 24.550 <0.001 No 1190 (57.8) 2353 (64.8) 775 (56.6) 2768 (64.1) Yes 869 (42.2) 1278 (35.2) 594 (43.4) 1553 (35.9) Seeing one's children daily 0.239 0.625 8.346 0.004 No 1055 (51.2) 1836 (50. 6) 649 (47.4) 2242 (51.9) Yes 1004 (48.8) 1795 (49.4) 720 (52.6) 2079 (48.1) Gender 87.881 <0.001 0.592 0.442 Female 873 (42.4) 2009 (55.3) 681 (49.7) 2201 (50.9) Male 1186 (57.6) 1622 (44.7) 688 (50.3) 2120 (49.1) Age/yr. 0.204 0.675 8.459 0.004 60-74 1810 (87.9) 3177 (87.5) 1169 (85.4) 3818 (88.4) ≥75 249 (12.1) 454 (12.5) 200 (16.8) 503 (11.6) Marital status 9.461 0.002 3.326 0.068 Single/divorced/widowed 377 (18.3) 551 (15.2) 245 (17.9) 683 (15.8) Married 1682 (81.7) 3080 (84.8) 1124 (82.1) 3638 (84.2) Education 60.446 <0.001 2.059 0.560 Illiteracy 946 (45.9) 1314 (36.2) 558 (40.8) 1702 (39.4) Primary school 559 (27.1) 1050 (28.9) 383 (28.0) 1226 (28.4) Junior high schooll 378 (18.4) 828 (22.8) 274 (20.0) 932 (21.6) High school and above 176 (8.5) 439 (12.1) 154 (11.2) 461 (10.7) Number of surviving children 13.653 <0.001 2.990 0.084 1 328 (15.9) 722 (19.9) 231 (16.9) 819 (19.0) ≥2 1731 (84.1) 2909 (80.1) 1138 (83.1) 3502 (81.0) Urban or rural residents 23.001 <0.001 0.019 0.901 Rural 1185 (57.6) 1850 (51.0) 728 (53.2) 2307 (53.4) Urban 874 (42.4) 1781 (49.0) 641 (46.8) 2014 (46.6) Current working status 1.287 0.257 20.533 <0.001 Unemployment 1003 (48.7) 1712 (47.1) 726 (53.0) 1989 (46.0) Employment 1056 (51.3) 1919 (52.9) 634 (47.0) 2332 (54.0) Personal annual income 35.217 <0.001 20.533 <0.001 Q1 546 (26.5) 894 (24.6) 315 (23.0) 1125 (26.0) Q2 575 (27.9) 869 (24.0) 392 (28.6) 1052 (24.3) Q3 518 (25.2) 880 (24.2) 296 (21.6) 1102 (25.5) Q4 420 (20.4) 988 (27.2) 366 (26.8) 1042 (24.1) Medical insurance 29.557 <0.001 19.623 <0.001 No 139 (6.8) 226 (6.2) 64 (4.7) 301 (7.3) Other medical insurance 43 (2.1) 138 (3.8) 54 (3.9) 127 (2.9) Medical insurance for urban workers 233 (11.3) 505 (13.9) 209 (15.3) 529 (12.2) Medical insurance for urban residents 153 (7.4) 331 (9.1) 112 (8.2) 372 (8.6) New rural cooperative medical insurance 1491 (72.4) 2431 (67.0) 930 (67.9) 2992 (69.2) Receiving retirement pension 19.413 <0.001 9.663 0.002 No 1723 (83.7) 2864 (78.9) 1064 (77.7) 3523 (81.5) Yes 336 (16.3) 767 (21.1) 305 (22.3) 798 (18.5) Receiving old-age pension 4.821 0.028 0.304 0.581 No 719 (34.9) 1374 (37.8) 495 (36.2) 1598 (37.0) Yes 1340 (65.1) 2257 (62.2) 874 (24.3) 2723 (63.0) Chronic diseases 163.730 <0.001 127.345 <0.001 No 1222 (59.3) 2744 (75.6) 787 (57.5) 3179 (73.6) Yes 837 (40.7) 887 (24.4) 582 (42.5) 1142 (26.4) Self-reported health status 313.456 <0.001 96.906 <0.001 Poor 827 (40.2) 703 (19.4) 501 (36.6) 1029 (23.8) General 469 (22.7) 874 (24.1) 322 (23.5) 1021 (23.6) Good 763 (37.1) 2054 (56.5) 546 (39.9) 2271 (52.6) Activities of daily living 63.606 <0.001 37.994 <0.001 Being unable to care for oneself independently 509 (24.7) 583 (16.1) 341 (24.9) 751 (17.4) Being able to care for oneself independently 1550 (75.3) 3048 (83.9) 102 (75.1) 3570 (82.6) 
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表 2 子女代际支持对老年人就医行为影响的logistic回归分析（n=5690）
Table 2. Logistic regression analysis of the effect of children's intergenerational support on the healthcare seeking behaviors of older adults (n=5690)
Variable Seeing a doctor in the last two weeks One-year hospitalization β Wald χ2 P OR (95% CI) β Wald χ2 P OR (95% CI) Financial support from children (No) Yes 0.121 4.007 0.045 1.129 (1.003-1.270) 0.059 0.790 0.374 1.061 (0.931-1.210) Daily care support from children (No) Yes 0.138 4.837 0.028 1.149 (1.015-1.299) 0.175 6.433 0.011 1.191 (1.040-1.363) Seeing one's children daily (No) Yes −0.081 1.809 0.179 0.922 (0.819-1.038) 0.124 3.472 0.062 1.132 (0.994-1.289) Gender (Male) Female 0.358 32.883 <0.001 1.430 (1.266-1.617) −0.066 0.918 0.338 0.936 (0.817-1.072) Age (60-74 yr.) ≥75 yr. −0.096 1.031 0.310 0.908 (0.754-1.094) 0.105 1.105 0.293 1.110 (0.914-1.349) Marital status (Single/divorced/widowed) Married −0.047 0.336 0.562 0.954 (0.812-1.120) 0.006 0.005 0.943 1.006 (0.844-1.200) Education (Illiteracy) 3.769 0.288 0.491 0.921 Primary school −0.120 2.551 0.099 0.887 (0.770-1.023) −0.001 0.000 0.988 0.999 (0.853-1.170) Junior high schooll and above −0.105 3.093 0.222 0.901 (0.761-1.065) −0.060 0.399 0.528 0.942 (0.782-1.135) High school and above −0.169 2.523 0.148 0.845 (0.672-1.061) −0.039 0.097 0.755 0.962 (0.754-1.227) Number of children (Have a surviving child) Having more than one surviving child 0.143 3.100 0.078 1.154 (0.984-1.353) 0.135 2.291 0.130 1.145 (0.961-1.364) Urban or rural residents (Rural) Urban −0.158 5.371 0.020 0.854 (0.748-0.976) −0.067 0.789 0.374 0.935 (0.806-1.084) Current working status (Unemployment) Employment 0.044 0.399 0.527 1.045 (0.912-1.197) −0.091 1.406 0.236 0.913 (0.786-1.061) Personal annual income (Q1) 3.531 0.317 11.085 0.011 Q2 −0.210 2.551 0.110 0.811 (0.627-1.049) 0.240 2.808 0.094 1.271 (0.960-1.683) Q3 −0.228 3.093 0.079 0.796 (0.618-1.026) −0.060 0.173 0.677 0.942 (0.712-1.247) Q4 −0.250 2.523 0.112 0.779 (0.572-1.060) 0.024 0.020 0.887 1.025 (0.730-1.438) Medical insurance (No) 6.767 0.149 15.543 0.004 Other medical insurance −0.353 2.375 0.123 0.703 (0.449-1.101) 0.681 8.446 0.004 1.976 (1.248-3.128) Medical insurance for urban workers 0.049 0.095 0.758 1.050 (0.769-1.434) 0.683 14.047 <0.001 1.980 (1.385-2.830) Medical insurance for urban residents −0.211 1.797 0.180 0.810 (0.595-1.102) 0.382 4.320 0.038 1.465 (1.022-2.100) New rural cooperative medical insurance −0.085 0.481 0.488 0.918 (0.722-1.168) 0.394 7.761 0.009 1.482 (1.103-1.993) Receiving retirement pension (No) Yes 0.096 0.579 0.447 1.100 (0.860-1.408) 0.184 1.822 0.177 1.202 (0.920-1.570) Receiving old-age pension (No) Yes 0.202 3.356 0.067 1.223 (0.986-1.518) −0.032 0.076 0.783 0.968 (0.769-1.219) Chronic diseases (Yes) No −0.533 69.114 <0.001 0.587 (0.517-0.665) −0.550 63.376 <0.001 0.577 (0.504-0.661) Self-reported health status (Poor) 137.954 <0.001 35.165 <0.001 General −0.566 49.028 <0.001 0.568 (0.485-0.665) −0.286 10.389 0.001 0.751 (0.631-0.894) Good −0.856 137.532 <0.001 0.425 (0.368-0.490) −0.479 35.163 <0.001 0.620 (0.529-0.726) Activities of daily living (Can't take care of yourself completely) Being able to care for oneself independently −0.193 6.420 0.011 0.824 (0.710-0.957) −0.228 7.761 0.005 0.796 (0.678-0.935) β: partial regression coefficient; OR: odd ratio; CI: confidence interval.
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[1] 国家卫生健康委统计信息中心. 2018年全国第六次卫生服务统计调查报告. 北京: 人民卫生出版社, 2021. [2] 宋全成, 尹康. 中国老年流动人口初诊就医行为选择及影响因素研究. 东岳论丛,2021(1): 136–147. [3] 郭斌, 程怀志, 张文雯, 等. 黑龙江省城市老年人卫生服务利用状况及其影响因素. 医学与社会,2019,32(6): 1–4. [4] 张栋. 代际支持、社会网络对老年人生活质量的影响—基于老化态度的中介效应分析. 中国劳动关系学院学报,2021,35(3): 15–25. [5] 公令臣, 高子雯, 王佳洛, 等. 家庭内代际支持与老年人抑郁的关系. 中国心理卫生杂志,2022,36(10): 856–861. doi: 10.3969/j.issn.1000-6729.2022.10.007 [6] 侯梦瑶, 傅虹桥, 付子璇, 等. 中国双向代际支持的变化趋势及对老年人门诊服务利用的影响研究. 卫生软科学,2021,35(8): 24–30. [7] 王奎, 李启明. 子女代际支持与老年人心理健康的关系: 自我老化态度和社会活动参与的中介作用. 西南交通大学学报(社会科学版),2021,22(3): 82–92. [8] HYWMRA B, CHIOU A F. Social media usage, social support, intergenerational relationships, and depressive symptoms among older adults. Geriatric Nursing,2020,41(5): 615–621. doi: 10.1016/j.gerinurse.2020.03.016 [9] 邱鹏飞. 家庭支持对老年人就医行为的影响--基于CHARLS数据的研究. 成都: 西南财经大学, 2020. [10] 杨桂宏, 杨永晓, 孙萍萍. 家庭代际支持对农村老年人就医行为的影响分析. 中共福建省委党校(福建行政学院)学报,2021(4): 130–137. [11] 侯建明, 张培东, 周文剑. 代际支持对中国老年人口心理健康状况的影响. 人口学刊,2021,43(5): 88–98. [12] LI Y W, CHI I. Correlates of physician visits among older adults in China: the effects of family support. J Aging Health,2011,23(6): 933–953. doi: 10.1177/0898264311401390 [13] 薄嬴. 代际支持对农村老年人医疗消费的影响—基于2011年CHARLS数据的分析. 消费经济,2016,32(5): 16–22. [14] 朱梦琦. 子女代际支持对农村老年人医疗服务利用的影响研究—基于CFPS的实证分析. 农村经济与科技,2019,30(9): 221–223. [15] 朱斌, 毛瑛. 代际支持、社会资本与医疗服务利用. 社会保障研究,2017(3): 48–59. doi: 10.3969/j.issn.1674-4802.2017.03.006 [16] 郑超, 才学韬. 家庭照料、医疗支出与老年人生活满意度. 山东大学学报(哲学社会科学版),2020(4): 134–145. doi: 10.19836/j.cnki.371100/c.2020.04.015 [17] 廖小利, 罗军飞, 罗阳. 代际支持对农村老年人医疗服务利用的影响研究—来自湖南的实证. 人口与发展,2017,23(6): 87–95. [18] 覃宁莉. 代际支持对农村地区老年人医疗服务利用的影响. 成都: 西南财经大学, 2019. [19] 侯梦瑶, 农圣, 韩汶静. 双向代际支持对老年人住院服务利用的影响路径研究. 医学与社会,2022,35(2): 46–50. -
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