Medical Treatment Behaviour of the Elderly Population in Shanghai: Group Features and Influencing Factor Analysis
Abstract
:1. Introduction
2. Method
2.1. Study Population: Shanghai Elderly Medical Demand Characteristics Questionnaire
- Personal information in order to understand basic demographic characteristics (gender, age, marital status, and relationship);
- Hukou (the Hukou system is one of the major tools of social control employed by the state. The Chinese system was designed not merely to provide population statistics and identify personal status, but also to directly regulate the population distribution and serve many other important objectives desired by the state. If a person holds Shanghai hukou, it means he is a Shanghai native and enjoys institutional benefits within the Shanghainese jurisdiction. In terms of medical insurance, the gap between local hukou and non-local hukou in enjoying medical services is even more obvious. Shanghai clearly stipulates that the non-local hukou population cannot hold the medical insurance card for urban residents in Shanghai and therefore, they cannot enjoy Shanghai’s basic medical security rights) place and residential place;
- Socioeconomic status (education level, employment, and income);
- Health status in order to understand the reason for the medical service (self-evaluation of physical health and whether it involves chronic disease (common chronic diseases are mainly cardiovascular and cerebrovascular diseases, cancer, diabetes, chronic respiratory diseases, among which cardiovascular and cerebrovascular diseases include hypertension, stroke, and coronary heart disease);
- Medical preference and expectation in order to understand medical habits and behavioural choices;
- Satisfaction of hospitals and medical services in order to understand the current situation of the hospital and medical service supply; and
- Medical insurance mode and the level of success in using it in order to understand medical security status (whether basic medical insurance is held).
- (1)
- A number of districts in the city’s central area, suburbs, and outer suburban areas; then
- (2)
- A number of streets in each district; and then
- (3)
- Neighbourhood committees in each street.
2.2. Dependent Variable
2.3. Independent Variables
2.4. Modelling and Estimation Methods
3. Results
3.1. Characteristics and Options
3.2. The Influencing Factors of Medical Treatment Choices for Physical Discomfort
3.3. The Influencing Factors of Medical Institution Choices in the Condition of General Disease and Severe Disease
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CHN | China |
MLR | Multinomial Logistic Regression |
CHNS | China Health and Nutrition Survey |
NHS | National Health Service |
IIA | Independence of Irrelevant Alternatives |
MLE | Maximum Likelihood Estimation |
Appendix A
Characteristics | General Disease | Severe Disease | ||||
---|---|---|---|---|---|---|
General Hospital N = 97 (22.10%) | District Hospital N = 163 (37.13%) | Specialised Hospitals or Community Clinic N = 179 (40.78%) | General Hospital N = 312 (71.07%) | District Hospital N = 65 (14.81%) | Specialised Hospitals or Community Clinic N = 62 (14.12%) | |
Gender | ||||||
Male | 46.83 | 34.22 | 32.23 | 35.71 | 40.40 | 31.52 |
Female | 53.17 | 65.78 | 67.77 | 64.29 | 59.60 | 68.48 |
Age | ||||||
60–64 years old | 30.16 | 29.33 | 28.21 | 28.34 | 28.28 | 33.70 |
65–69 years old | 36.50 | 30.67 | 29.31 | 33.64 | 30.31 | 20.65 |
70–74 years old | 14.29 | 19.11 | 22.34 | 18.66 | 21.21 | 21.74 |
75–79 years old | 5.50 | 13.78 | 9.52 | 8.53 | 11.11 | 17.39 |
80 years old and above | 13.49 | 7.11 | 10.62 | 10.83 | 9.09 | 6.52 |
Income (retirement pension) | ||||||
<1000 Yuan | 3.17 | 3.11 | 6.62 | 4.61 | 6.12 | 3.26 |
1000–1999 Yuan | 8.73 | 18.22 | 19.85 | 15.21 | 29.60 | 11.96 |
2000–2999 Yuan | 11.11 | 9.33 | 8.82 | 8.53 | 11.22 | 11.96 |
3000–3999 Yuan | 34.13 | 40.88 | 39.71 | 40.55 | 26.53 | 45.65 |
4000–4999 Yuan | 23.02 | 17.33 | 14.34 | 17.05 | 16.33 | 18.48 |
5000–5999 Yuan | 8.73 | 6.22 | 4.78 | 6.45 | 4.08 | 6.52 |
6000 Yuan and above | 11.11 | 4.89 | 5.88 | 7.60 | 6.12 | 2.17 |
Marital status | ||||||
Unmarried | 2.38 | 1.34 | 1.83 | 1.84 | 1.01 | 2.17 |
Married | 75.40 | 81.69 | 82.42 | 79.91 | 85.86 | 79.35 |
Divorced | 3.17 | 2.68 | 0.73 | 1.62 | 4.04 | 1.09 |
Widowed | 19.05 | 14.29 | 15.02 | 16.63 | 9.09 | 17.39 |
Cohabitation status | ||||||
Living alone | 7.94 | 8.44 | 9.89 | 9.45 | 5.05 | 10.87 |
Living with spouse | 47.62 | 46.22 | 52.38 | 47.93 | 56.57 | 46.75 |
With elder (same generation) | 5.55 | 3.11 | 2.56 | 2.99 | 3.03 | 5.43 |
With children | 30.95 | 28.45 | 23.81 | 26.27 | 27.27 | 30.43 |
With three generations | 7.94 | 13.78 | 11.36 | 13.36 | 8.08 | 6.52 |
Education level | ||||||
Primary school and below | 14.40 | 23.56 | 21.98 | 19.17 | 32.32 | 17.39 |
Middle school | 40.80 | 40.00 | 45.05 | 43.42 | 36.36 | 44.56 |
High school or technical secondary school | 31.20 | 24.00 | 20.88 | 24.48 | 23.24 | 22.83 |
Junior college | 13.60 | 12.44 | 12.09 | 12.93 | 8.08 | 15.22 |
Rural or Urban | ||||||
Urban | 96.83 | 89.29 | 84.50 | 89.84 | 79.59 | 93.41 |
Rural | 3.17 | 10.71 | 15.50 | 10.16 | 20.41 | 6.59 |
Shanghai Hukou | ||||||
Yes | 96.00 | 95.11 | 94.83 | 94.47 | 94.90 | 98.89 |
No | 4.00 | 4.89 | 5.17 | 5.53 | 5.10 | 1.11 |
Health condition | ||||||
Healthy | 53.97 | 40.63 | 42.49 | 42.49 | 45.46 | 50.00 |
Basic level of health | 34.92 | 46.88 | 43.22 | 42.73 | 42.42 | 43.48 |
Unhealthy | 11.11 | 12.49 | 14.29 | 14.78 | 12.12 | 6.52 |
Chronic disease | ||||||
no | 33.60 | 31.56 | 31.14 | 30.48 | 30.30 | 39.13 |
Yes | 66.40 | 68.44 | 68.86 | 69.52 | 69.70 | 60.87 |
The level of the subjectively nearest hospital from home | ||||||
level-2 | 31.58 | 48.28 | 46.47 | 40.75 | 50.60 | 53.95 |
level-3 | 68.42 | 51.72 | 53.53 | 59.25 | 49.40 | 46.05 |
The subjective distance to the nearest hospital | ||||||
<1 km | 2.83 | 9.04 | 6.63 | 5.64 | 13.33 | 4.41 |
1–2 km | 33.95 | 29.38 | 19.39 | 25.52 | 22.67 | 33.82 |
2–5 km | 39.62 | 35.59 | 38.27 | 39.76 | 26.67 | 39.71 |
5–10 km | 8.49 | 7.91 | 7.65 | 7.42 | 12.00 | 5.88 |
10 km and above | 15.09 | 18.08 | 28.06 | 21.66 | 25.33 | 16.18 |
The level of the objectively nearest hospital from home | ||||||
level-2 | 65.08 | 77.78 | 76.92 | 70.97 | 80.81 | 86.96 |
level-3 | 34.92 | 22.22 | 23.08 | 29.03 | 19.19 | 13.04 |
The objective distance to the nearest hospital | ||||||
<1 km | 51.59 | 39.56 | 32.97 | 39.41 | 35.35 | 41.30 |
1–2 km | 30.16 | 36.00 | 30.03 | 35.48 | 24.24 | 26.09 |
2–5 km | 11.11 | 14.22 | 25.64 | 17.74 | 21.22 | 19.57 |
5 km and above | 7.14 | 10.22 | 11.36 | 7.37 | 19.19 | 13.04 |
Understand medical insurance reimbursement policy | ||||||
Yes | 66.67 | 70.40 | 67.77 | 70.44 | 58.59 | 70.33 |
No | 33.33 | 29.60 | 32.23 | 29.56 | 41.41 | 29.67 |
Prefer medical institutions with higher reimbursement rate | ||||||
Yes | 33.33 | 35.71 | 43.95 | 37.79 | 45.45 | 37.36 |
No | 38.10 | 33.93 | 28.21 | 32.72 | 33.33 | 28.57 |
Not sure | 28.57 | 30.36 | 27.84 | 29.49 | 21.22 | 34.07 |
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Characteristics | Going to Hospital N = 284 (64.69%) | Going to Pharmacy N = 111 (25.28%) | Enduring N = 30 (6.83%) | Other Measures N = 14 (3.19%) |
---|---|---|---|---|
Gender | ||||
Male | 36.16 | 38.16 | 25.53 | 36.00 |
Female | 63.84 | 61.84 | 74.47 | 64.00 |
Age | ||||
60–64 years old | 25.69 | 36.84 | 27.66 | 40.00 |
65–69 years old | 31.17 | 30.92 | 29.79 | 36.00 |
70–74 years old | 20.70 | 15.13 | 25.53 | - |
75–79 years old | 11.22 | 8.55 | 12.77 | 16.00 |
80 years old and above | 11.22 | 8.56 | 4.25 | 8.00 |
Income (retirement pension) | ||||
<1000 Yuan | 4.75 | 4.61 | 6.38 | - |
1000–1999 Yuan | 15.50 | 24.34 | 10.64 | 8.00 |
2000–2999 Yuan | 7.25 | 15.79 | 10.64 | 4.00 |
3000–3999 Yuan | 40.75 | 30.26 | 57.45 | 32.00 |
4000–4999 Yuan | 18.50 | 14.47 | 8.50 | 28.00 |
5000–5999 Yuan | 6.25 | 5.92 | 2.13 | 12.00 |
6000 Yuan and above | 7.00 | 4.61 | 4.26 | 16.00 |
Marital status | ||||
Unmarried | 0.25 | 3.31 | 2.13 | 16.00 |
Married | 81.05 | 82.12 | - | - |
Divorced | 2.49 | 1.32 | 80.85 | 68.00 |
Widowed | 16.21 | 13.25 | 17.02 | 16.00 |
Cohabitation status | ||||
Living alone | 8.24 | 7.89 | 10.64 | 24.00 |
Living with spouse | 51.87 | 46.05 | 42.55 | 36.00 |
With elder (same generation) | 2.74 | 2.64 | 8.51 | 8.00 |
With children | 26.68 | 26.97 | 29.79 | 28.00 |
With three generations | 10.47 | 16.45 | 8.51 | 4.00 |
Education level | ||||
Primary school and below | 19.00 | 27.63 | 19.15 | 16.00 |
Middle school | 43.75 | 42.76 | 40.43 | 24.00 |
High school or technical secondary school | 25.50 | 19.08 | 21.28 | 36.00 |
Junior college | 11.75 | 10.53 | 19.14 | 24.00 |
Rural or Urban | ||||
Urban | 89.45 | 84.21 | 95.74 | 92.00 |
Rural | 10.55 | 15.79 | 4.26 | 8.00 |
Shanghai Hukou | ||||
Yes | 97.49 | 90.73 | 93.62 | 88.00 |
No | 2.51 | 9.27 | 6.38 | 12.00 |
Health condition | ||||
Healthy | 42.00 | 53.29 | 29.79 | 48.00 |
Basic level of health | 45.00 | 33.55 | 51.06 | 48.00 |
Unhealthy | 13.00 | 13.16 | 19.15 | 4.00 |
Chronic disease | ||||
No | 28.00 | 38.82 | 27.66 | 56.00 |
Yes | 72.00 | 61.18 | 72.34 | 44.00 |
The level of the subjectively nearest hospital from home | ||||
level-2 | 42.78 | 48.23 | 41.03 | 42.11 |
level-3 | 57.22 | 51.77 | 58.97 | 57.89 |
The subjective distance to the nearest hospital | ||||
<1 km | 5.71 | 6.90 | 8.83 | 20.00 |
1–2 km | 27.31 | 28.45 | 11.76 | 20.00 |
2–5 km | 37.78 | 31.90 | 58.83 | 33.33 |
5–10 km | 8.57 | 6.03 | 8.83 | 6.67 |
10 km and above | 20.63 | 26.72 | 11.76 | 20.00 |
The level of the objectively nearest hospital from home | ||||
level-2 | 75.31 | 73.03 | 76.60 | 76.00 |
level-3 | 24.69 | 26.97 | 23.40 | 24.00 |
The objective distance to the nearest level-3 hospital | ||||
<1 km | 37.40 | 40.13 | 55.32 | 28.00 |
1–2 km | 33.67 | 29.61 | 25.53 | 40.00 |
2–5 km | 16.96 | 22.37 | 17.02 | 24.00 |
5 km and above | 11.97 | 7.89 | 2.13 | 8.00 |
Understand medical insurance reimbursement policy | ||||
Yes | 66.17 | 65.79 | 87.23 | 88.00 |
No | 33.83 | 34.21 | 12.77 | 12.00 |
Prefer medical institutions with higher reimbursement rate | ||||
Yes | 39.25 | 42.76 | 29.79 | 28.00 |
No | 32.75 | 30.92 | 31.91 | 32.00 |
Not sure | 28.00 | 26.32 | 38.30 | 40.00 |
Characteristics | Going to Pharmacy | Enduring | Other Measures | |||
---|---|---|---|---|---|---|
Odds Ratio | 95%CI | Odds Ratio | 95%CI | Odds Ratio | 95%CI | |
Demographic and economic characteristics: | ||||||
Gender | ||||||
Male | Reference | Reference | Reference | |||
Female | 0.76 | (0.40, 1.45) | 0.65 | (0.21, 2.01) | 0.90 | (0.07, 11.05) |
Age | ||||||
60–64 years old | Reference | Reference | Reference | |||
65–69 years old | 0.72 | (0.37, 1.38) | 0.64 | (0.18, 2.18) | 0.25 | (0.02, 2.9) |
70–74 years old | 0.46 * | (0.20, 1.06) | 0.61 | (0.15, 2.46) | 0.74 | (0.05, 11.87) |
75–79 years old | 0.59 | (0.22, 1.55) | 1.32 | (0.27, 6.53) | 0.00 | (0.00, .) |
80 years old and above | 0.27 ** | (0.09, 0.88) | 0.17 | (0.01, 2.20) | 0.19 | (0.00, 10.77) |
Income(retirement pension) | ||||||
<1000 Yuan | Reference | Reference | Reference | |||
1000–1999 Yuan | 6.92 ** | (1.20, 39.97) | 1.68 | (0.07, 40.69) | 7.25 × 106 | (0.00, .) |
2000–2999 Yuan | 2.02 | (0.35, 11.73) | 2.45 | (0.11, 53.73) | 2.70 × 107 | (0.00, .) |
3000–3999 Yuan | 1.07 | (0.20, 5.79) | 1.80 | (0.09, 36.34) | 7.41 × 108 | (0.00, .) |
4000–4999 Yuan | 1.06 | (0.18, 6.31) | 0.62 | (0.02, 16.46) | 7.32 × 108 | (0.00, .) |
5000–5999 Yuan | 1.10 | (0.17, 7.29) | 0.52 | (0.01, 19.53) | 7.23 × 109 | (0.00, .) |
6000 Yuan and above | 0.78 | (0.11, 5.76) | 0.68 | (0.02, 21.91) | 2.09 × 109 | (0.00, .) |
Marital status | ||||||
Unmarried | 17.85 ** | (1.37, 232.55) | 0.00 | (0, .) | 13.71 | (0.11, 1739.55) |
Married | Reference | Reference | Reference | |||
Divorced | 0.15 | (0.02, 1.48) | 0.00 | (0.00, .) | 0.00 | (0.00, .) |
Widowed | 0.99 | (0.35, 2.77) | 0.61 | (0.09, 4.27) | 0.15 | (0.00, 7.09) |
Cohabitation status | ||||||
Living alone | 1.31 | (0.36, 4.83) | 4.70 | (0.50, 44.18) | 97.47 ** | (2.70, 3518.98) |
Living with spouse | Reference | Reference | Reference | |||
With elder (same generation) | 0.96 | (0.18, 5.16) | 2.01 | (0.22, 18.67) | 4.99 | (0.1, 253.48) |
With children | 1.25 | (0.65, 2.41) | 0.73 | (0.20, 2.67) | 3.83 | (0.5, 29.16) |
With three generations | 1.18 | (0.51, 2.71) | 0.71 | (0.16, 3.23) | 0.00 | (0.00, .) |
Education level | ||||||
Primary school and below | Reference | Reference | Reference | |||
Middle school | 0.72 | (0.33, 1.57) | 0.44 | (0.10, 1.92) | 0.37 | (0.01, 9.86) |
High school or technical secondary school | 0.47 | (0.19, 1.20) | 0.69 | (0.14, 3.41) | 0.37 | (0.01, 10.31) |
Junior college | 0.83 | (0.27, 2.59) | 1.27 | (0.18, 8.99) | 1.61 | (0.03, 75.17) |
Rural or Urban | ||||||
Urban | 1.02 | (0.18, 5.61) | 1.01 | (0.03, 36.54) | 0.04 | (0.00, 390.24) |
Rural | Reference | Reference | Reference | |||
Shanghai Hukou | ||||||
Yes | 0.11 *** | (0.02, 0.49) | 0.06 ** | (0.00, 0.68) | 4080.37 | (0.00, .) |
No | Reference | Reference | Reference | |||
Medical demand characteristics: | ||||||
Health condition | ||||||
Healthy | Reference | Reference | Reference | |||
Basic level of health | 1.04 | (0.60, 1.81) | 1.07 | (0.37, 3.07) | 1.95 | (0.30, 12.51) |
Unhealthy | 1.15 | (0.51, 2.59) | 2.23 | (0.63, 7.94) | 5.35 | (0.18, 156.41) |
Chronic disease | ||||||
No | Reference | Reference | Reference | |||
Yes | 0.54 ** | (0.31, 0.93) | 0.74 | (0.26, 2.09) | 0.11 ** | (0.02, 0.84) |
Medical resource availability: | ||||||
The level of the subjectively nearest hospital from home | ||||||
level-2 | Reference | Reference | Reference | |||
level-3 | 0.57 | (0.06, 5.23) | 0.00 | (0.00, .) | 0.04 | (0.00,21.82) |
The subjective distance to the nearest hospital | ||||||
Distance from Level-3 hospital <1 km | Reference | Reference | Reference | |||
1–2 km | 0.66 | (0.10, 4.53) | 1.36 × 107 | (0.00, .) | 0.04 | (0.00, 52.06) |
2–5 km | 0.91 | (0.14, 5.76) | 5.24 × 107 | (0.00, .) | 1.04 | (0.00, 326.2) |
5–10 km | 0.31 | (0.04, 2.59) | 1.21 × 107 | (0.00, .) | 0.00 | (0.00, .) |
10 km and above | 0.51 | (0.06, 3.99) | 2.45 × 107 | (0.00, .) | 3.66 | (0.01, 1371.82) |
Distance from Level-2 hospital <1 km | Reference | Reference | Reference | |||
1–2 km | 0.93 | (0.24, 3.55) | 0.00 | (0.00, .) | 0.01 ** | (0.00, 0.48) |
2–5 km | 0.31 | (0.07, 1.48) | 1.62 | (0.18, 14.39) | 0.00 ** | (0.00, 0.57) |
5–10 km | 0.27 | (0.02, 3.94) | 44.07* | (0.66, 2920.79) | 37.07 | (0.09, 14,913.39) |
10 km and above | 0.22 * | (0.04, 1.32) | 2.11 | (0.08, 55.02) | 0.06 | (0.00, 6.64) |
The level of the objectively nearest hospital from home | ||||||
level-2 | Reference | Reference | Reference | |||
level-3 | 1.36 | (0.44, 4.15) | 1.09 | (0.20, 6.10) | 0.00 | (0.00, .) |
The objective distance to the nearest level-3 hospital | ||||||
Distance from Level-3 hospital <1 km | Reference | Reference | Reference | |||
1–2 km | 0.75 | (0.21, 2.65) | 0.31 | (0.03, 2.82) | 2.17 × 107 | (0.00, .) |
2–5 km | 0.56 | (0.07, 4.56) | 0.16 | (0.00, 5.72) | 2.91 × 107 | (0.00, .) |
5 km and above | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 1.84 × 106 | (0.00, .) |
Distance from Level-2 hospital <1 km | Reference | Reference | Reference | |||
1–2 km | 0.85 | (0.36, 2.00) | 0.15 ** | (0.03, 0.76) | 1.11 | (0.07, 18.32) |
2–5 km | 1.97 | (0.54, 7.18) | 0.05 * | (0.00, 1.13) | 1.28 | (0.04, 37.65) |
5 km and above | 0.16** | (0.03, 0.91) | 0.09 | (0.00, 2.70) | 0.00 | (0.00, .) |
Medical expenditure: | ||||||
Understand medical insurance reimbursement policy | ||||||
Yes | 0.87 | (0.50, 1.52) | 0.26 ** | (0.07, 0.93) | 0.16 | (0.01, 2.00) |
No | Reference | Reference | Reference | |||
Prefer medical institutions with higher reimbursement rate | ||||||
Yes | Reference | Reference | Reference | |||
No | 0.96 | (0.52, 1.77) | 1.48 | (0.44, 4.95) | 0.70 | (0.05, 10.24) |
Not sure | 0.86 | (0.46, 1.62) | 2.37 | (0.77, 7.31) | 7.86 * | (0.92, 67.02) |
Constant | 20.51 ** | (1.02, 411.47) | 11.11 | (0.06, 2029.61) | 0.00 | (0.00, .) |
Observations | 439 | 439 | 439 | |||
r2_p | 0.219 | 0.219 | 0.219 |
General Disease | Severe Disease | |||||||
---|---|---|---|---|---|---|---|---|
Characteristics | District Hospital | Other Specialised Hospitals or Community Clinics | District Hospital | Other Specialised Hospitals or Community Clinics | ||||
Odds Ratio | 95%CI | Odds Ratio | 95%CI | Odds Ratio | 95%CI | Odds Ratio | 95%CI | |
Demographic and economic characteristics: | ||||||||
Gender | ||||||||
Male | Reference | Reference | Reference | Reference | ||||
Female | 1.73 | (0.82, 3.67) | 1.37 | (0.64, 2.90) | 1.59 | (0.72, 3.49) | 0.97 | (0.42, 2.21) |
Age | ||||||||
60–64 years old | Reference | Reference | Reference | Reference | ||||
65–69 years old | 0.65 | (0.30, 1.40) | 0.54 | (0.25, 1.17) | 0.73 | (0.31, 1.71) | 0.55 | (0.23, 1.31) |
70–74 years old | 1.68 | (0.65, 4.31) | 1.98 | (0.77, 5.12) | 1.31 | (0.49, 3.5) | 0.92 | (0.34, 2.48) |
75–79 years old | 2.83 * | (0.87, 9.24) | 1.43 | (0.41, 4.97) | 2.95* | (0.88, 9.92) | 1.48 | (0.47, 4.65) |
80 years old and above | 0.77 | (0.21, 2.85) | 1.42 | (0.41, 4.84) | 2.14 | (0.58, 7.95) | 0.26 | (0.04, 1.75) |
Income (retirement pension) | ||||||||
<1000 Yuan | Reference | Reference | Reference | Reference | ||||
1000–1999 Yuan | 0.54 | (0.04, 8.09) | 0.47 | (0.03, 7.24) | 0.21 * | (0.03, 1.23) | 1.27 × 106 | (0.00, .) |
2000–2999 Yuan | 0.27 | (0.02, 3.46) | 0.19 | (0.01, 2.59) | 0.13 * | (0.02, 1.06) | 2.53 × 106 | (0.00, .) |
3000–3999 Yuan | 0.71 | (0.06, 8.79) | 0.76 | (0.06, 9.82) | 0.43 | (0.07, 2.52) | 1.88 × 106 | (0.00, .) |
4000–4999 Yuan | 0.47 | (0.04, 6.01) | 0.40 | (0.03, 5.39) | 0.26 | (0.04, 1.72) | 1.02 × 106 | (0.00, .) |
5000–5999 Yuan | 0.32 | (0.02, 4.45) | 0.27 | (0.02, 3.97) | 0.07 ** | (0.01, 0.71) | 6.80 × 106 | (0.00, .) |
6000 Yuan and above | 0.39 | (0.03, 5.81) | 0.31 | (0.02, 4.89) | 0.36 | (0.04, 3.11) | 1.19 × 105 | (0.00, .) |
Marital status | ||||||||
Unmarried | 0.67 | (0.06, 7.20) | 1.14 | (0.09, 15.29) | 0.64 | (0.04, 10.97) | 1.08 | (0.13, 8.90) |
Married | Reference | Reference | Reference | Reference | ||||
Divorced | 0.18** | (0.03, 0.98) | 0.11 ** | (0.01, 0.78) | 3.23 | (0.58, 17.89) | 0.45 | (0.04, 4.61) |
Widowed | 0.42 | (0.13, 1.33) | 0.60 | (0.19, 1.94) | 0.55 | (0.14, 2.22) | 0.88 | (0.26, 3.02) |
Cohabitation status | ||||||||
Living alone | 2.18 | (0.52, 9.19) | 2.26 | (0.55, 9.19) | 0.91 | (0.17, 4.8) | 1.43 | (0.32, 6.32) |
Living with spouse | Reference | Reference | Reference | Reference | ||||
With elder (same generation) | 1.22 | (0.25, 6.02) | 0.30 | (0.05, 1.92) | 1.27 | (0.12, 13.07) | 2.02 | (0.43, 9.61) |
With children | 2.29** | (1.04, 5.07) | 1.28 | (0.57, 2.85) | 1.45 | (0.6, 3.47) | 1.30 | (0.58, 2.93) |
With three generations | 2.59* | (0.89, 7.55) | 2.15 | (0.72, 6.44) | 0.30 * | (0.08, 1.07) | 1.20 | (0.36, 4.08) |
Education level | ||||||||
Primary school and below | Reference | Reference | Reference | Reference | ||||
Middle school | 0.87 | (0.32, 2.35) | 1.55 | (0.56, 4.24) | 0.77 | (0.30, 1.95) | 0.99 | (0.32, 3.03) |
High school or technical secondary school | 0.70 | (0.24, 2.05) | 0.87 | (0.29, 2.62) | 0.90 | (0.30, 2.71) | 0.80 | (0.22, 2.90) |
Junior college | 1.07 | (0.30, 3.85) | 1.29 | (0.34, 4.81) | 1.13 | (0.30, 4.27) | 2.18 | (0.54, 8.72) |
Rural or Urban | ||||||||
Urban | 0.33 | (0.03, 3.21) | 0.59 | (0.06, 5.78) | 0.17 * | (0.02, 1.28) | 6.18 | (0.47, 81.41) |
Rural | Reference | Reference | Reference | Reference | ||||
Hukou | ||||||||
Yes | 0.58 | (0.07, 5.02) | 0.52 | (0.06, 4.75) | 0.46 | (0.08, 2.64) | 2.65 × 106 | (0.00, .) |
No | Reference | Reference | Reference | Reference | ||||
Medical demand characteristics: | ||||||||
Health condition | ||||||||
Healthy | Reference | Reference | Reference | Reference | ||||
Basic level of health | 2.12 ** | (1.10, 4.06) | 1.79 * | (0.93, 3.46) | 1.24 | (0.62, 2.48) | 0.97 | (0.50, 1.88) |
Unhealthy | 1.30 | (0.48, 3.49) | 1.62 | (0.61, 4.30) | 0.99 | (0.35, 2.75) | 0.09 ** | (0.01, 0.80) |
Chronic disease | ||||||||
No | Reference | Reference | Reference | Reference | ||||
Yes | 0.95 | (0.49, 1.84) | 0.72 | (0.37, 1.39) | 1.31 | (0.63, 2.73) | 0.67 | (0.33, 1.34) |
Medical resource availability: | ||||||||
The level of the subjectively nearest hospital from home | ||||||||
level-2 | Reference | Reference | Reference | Reference | ||||
level-3 | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 2.29 | (0.18, 29.03) | 4.23 | (0.15, 123.22) |
The subjective distance to the nearest hospital | ||||||||
Distance from Level-3 hospital <1 km | Reference | Reference | Reference | Reference | ||||
1–2 km | 1.42 | (0.16, 12.62) | 0.44 | (0.05, 3.72) | 0.05 ** | (0.00, 0.67) | 0.32 | (0.02, 4.58) |
2–5 km | 1.46 | (0.17, 12.27) | 1.01 | (0.13, 7.71) | 0.07 ** | (0.01, 0.73) | 0.37 | (0.03, 4.88) |
5–10 km | 0.92 | (0.09, 9.55) | 0.35 | (0.04, 3.47) | 0.13 | (0.01, 1.66) | 0.24 | (0.01, 4.46) |
10 km and above | 1.27 | (0.12, 13.23) | 0.70 | (0.07, 6.62) | 0.16 | (0.01, 1.94) | 0.07 * | (0.00, 1.54) |
Distance from Level-2 hospital <1 km | Reference | Reference | Reference | Reference | ||||
1–2 km | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 0.24 ** | (0.06, 0.96) | 3.23 | (0.34, 31.2) |
2–5 km | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 0.12 ** | (0.02, 0.61) | 1.51 | (0.13, 16.96) |
5–10 km | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 5.05 | (0.30, 84.72) | 0.00 | (0.00, .) |
10 km and above | 0.00 | (0.00, .) | 0.00 | (0.00, .) | 0.17 * | (0.02, 1.24) | 1.62 | (0.11, 23.88) |
The level of the objectively nearest hospital from home | ||||||||
level-2 | Reference | Reference | Reference | Reference | ||||
level-3 | 0.32 * | (0.1, 1) | 0.19 ** | (0.05, 0.73) | 0.00 | (0.00, .) | 1.21 | (0.31, 4.72) |
The objective distance to the nearest level hospital | ||||||||
Distance from Level-3 hospital <1 km | Reference | Reference | Reference | Reference | ||||
1–2 km | 3.21 * | (0.88, 11.70) | 5.17 ** | (1.2, 22.32) | 4.65 × 106 | (0.00, .) | 0.63 | (0.13, 2.99) |
2–5 km | 6.10 | (0.40, 94.03) | 44.85 *** | (2.78, 724.03) | 4.42 × 106 | (0.00, .) | 0.00 | (0.00, .) |
5 km and above | 10.78 | (0.00, .) | 0.00 | (0.00, .) | 1.58 × 1016 | (0.00, .) | 2.58 × 106 | (0.00, .) |
Distance from Level-2 hospital <1 km | Reference | Reference | Reference | Reference | ||||
1–2 km | 2.60 * | (0.97, 6.99) | 2.30 | (0.84, 6.32) | 0.81 | (0.28, 2.37) | 1.59 | (0.58, 4.30) |
2–5 km | 1.18 | (0.25, 5.49) | 3.35 * | (0.81, 13.88) | 0.42 | (0.06, 3.18) | 4.59 ** | (1.00, 20.96) |
5 km and above | 4.49 | (0.57, 35.40) | 6.52 * | (0.82, 51.57) | 0.76 | (0.09, 6.43) | 3.36 | (0.40, 28.24) |
Medical expenditure: | ||||||||
Understand medical insurance reimbursement policy | ||||||||
Yes | 1.10 | (0.56, 2.16) | 1.20 | (0.61, 2.34) | 1.68 | (0.85, 3.29) | 1.78 | (0.83, 3.80) |
No | Reference | Reference | Reference | Reference | ||||
Prefer medical institutions with higher reimbursement rate | ||||||||
Yes | Reference | Reference | Reference | Reference | ||||
No | 0.76 | (0.37, 1.57) | 0.46 ** | (0.22, 0.95) | 1.30 | (0.63, 2.69) | 0.85 | (0.38, 1.93) |
Not sure | 0.76 | (0.35, 1.61) | 0.62 | (0.29, 1.31) | 0.53 | (0.23, 1.23) | 1.37 | (0.63, 2.98) |
Constant | 3.82 × 107 | (0.00, .) | 2.59 × 107 | (0.00, .) | 18.82 * | (0.61, 581.28) | 0.00 | (0.00, .) |
Observations | 439 | 439 | 439 | 439 | ||||
r2_p | 0.147 | 0.147 | 0.21 | 0.21 |
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Yang, S.; Wang, D.; Li, C.; Wang, C.; Wang, M. Medical Treatment Behaviour of the Elderly Population in Shanghai: Group Features and Influencing Factor Analysis. Int. J. Environ. Res. Public Health 2021, 18, 4108. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084108
Yang S, Wang D, Li C, Wang C, Wang M. Medical Treatment Behaviour of the Elderly Population in Shanghai: Group Features and Influencing Factor Analysis. International Journal of Environmental Research and Public Health. 2021; 18(8):4108. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084108
Chicago/Turabian StyleYang, Shangguang, Danyang Wang, Chen Li, Chunlan Wang, and Mark Wang. 2021. "Medical Treatment Behaviour of the Elderly Population in Shanghai: Group Features and Influencing Factor Analysis" International Journal of Environmental Research and Public Health 18, no. 8: 4108. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084108