养老服务利用对老年人自评健康的影响——基于CHARLS的实证分析
The Influence of the Utilization of Old-Age Care Services on the Self-Rated Health of the Elderly—An Empirical Analysis Based on CHARLS

目的：探究养老服务利用对老年人自评健康的影响，为优化养老服务、改善老年人健康状况提供依据。方法：基于CHARLS 2018年调查数据，利用二元logistic回归分析不同养老服务利用对老年人自评健康的影响。结果：老年人以居家养老为主，但社区居家养老服务利用严重不足、物质保障养老服务和健康保障养老服务偏基本，79.7%的老年人自评为不健康。其中，医疗服务与自评健康显著负相关，养老保险、补充养老金、医疗保险和家庭医生签约服务与自评健康为负相关，社区居家养老服务、养老金和长护险与自评健康为正相关；性别、受教育水平、婚姻状态、民族、生活方式和抑郁与自评健康显著相关，年龄、政治面貌、住宅地址与自评健康正相关。建议：积极发展普惠型社区居家养老服务，鼓励机构养老；继续扩大养老保险和医疗保险覆盖面，落实家庭医生签约服务并积极推广长期护理保险；关注老年人心理健康和差异化需求；对残疾、失能、高龄等老年群体进行能力评估。
Objective: To explore the influence of the utilization of old-age care services on the self-rated health of the elderly, and to provide a basis for optimizing old-age care services and improving their health status. Methods: Based on the survey data of CHARLS in 2018, the effects of different utilization of old-age care services on the self-rated health of the elderly were analyzed by binary logistic regression. Results: The elderly mainly care for the elderly at home, but the community home care service is seriously underused, and the material security service and health security service are basic. 79.7% of the elderly rated themselves as unhealthy. Among them, medical service is negatively correlated with self-rated health, old-age insurance, supplementary pension, medical insurance and family doctor contract service are negatively correlated with self-rated health, and community home care service, pension and long-term care insurance are positively correlated with self-rated health; Gender, education level, marital status, nationality, lifestyle and depression are significantly related to self-rated health, while age, political outlook and residential address are positively related to self-rated health. Suggestions: Actively developing home-based care services in inclusive communities and encouraging institutional care for the elderly; Continuing to expand the coverage of old-age insurance and medical insurance, implementing family doctor contract service and actively promoting long-term care insurance; Paying attention to the mental health and differentiated needs of the elderly; Evaluating the ability of the disabled, elderly and other elderly groups.