城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下，发现就医惯性的存在；并运用集中指数分解法发现，卫生服务的利用存在不公平，偏向于富人，而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。

The Inertia of Medical Care Conducts and the Unfair of the Utilization of the Health Care Services in the Elderly between City and Countryside

There were many papers about the unfair of the utilization of the health care services in the elderly between city and coun-tryside, but most of these researches ignored the existence of the inertia of medical care conducts in the elderly from the long-term urban-rural differences. After controlling the variable of income,security,medical accessibility,this research found the existence of the inertia of medical care conducts. After using the method of the concentrated index decomposition ,the study found that the use of health care services were unfair , because the rich used much more health care services. Between the use of two kinds of medical care services,the inertia of medical care conducts’ contribution were 12%and 5%respectively. This kind of urban-rural difference lead to the body health, mental health and the ability of look for themselves of the elderly in rural areas were significantly lower than the el-derly in urban areas. On the basis ,we summarized the conclusion of this research and explored relevant significances for policy.