医养结合对老年人身心健康的影响：机制与经验证据The Impact of Integrated Medical and Nursing Care on Elderly Health: Mechanisms and Empirical Evidence
倪晨旭,李民,潘伟祥,王震
摘要(Abstract)：
为满足老年人对高品质健康养老的需求，医养结合已成为必然趋势。我国已先后开展两批国家级医养结合试点，初步探索形成了契合国情的医养结合模式。然而，目前对此还缺乏具有政策涵义的系统评估，主要原因在于尚未清晰地论证医养结合影响老年人健康的理论机制及具体作用路径。基于此，本文利用全国代表性老年追踪调查数据，从理论和实证两方面探讨了医养结合政策对老年人健康的影响。双重差分模型的估计结果显示，医养结合政策的实施显著提升了老年人的身心健康水平，涵盖自我健康评估、抑郁风险以及社会适应能力等多项关键指标。机制分析发现，医养结合政策不仅为老年人提供了更优质便捷的医养服务，还从多个层面增进了社会凝聚力。一方面，医养结合优化了社会资本配置，为老年人创造了更友好的生活环境；另一方面，政策的实施强化了尊老、爱老与助老的社会氛围，显著增强了老年人对生活地区的归属感，从而促进了其心理福祉。此外，医养结合通过改善老年群体的社交网络，拓展了其社会互动范围，为老年人提供了更多的情感支持与心理慰藉。异质性分析表明，医养结合政策对女性以及社会经济地位较高的老年人健康改善效果更为显著。城乡层面，政策效果并未表现出显著差异，但在户籍层面，本地户籍老人的健康改善幅度明显高于外地户籍老人。从区域差异来看，经济发达和医疗资源较为丰富地区的政策效果更大，这反映出当前医养结合服务在公平性方面仍存在一定不足。本文研究结论对于全面评估医养结合政策效果以及优化现有医养结合运营模式具有重要现实启示。
关键词(KeyWords)： 医养结合;老年健康;社区居家养老;积极老龄化
基金项目(Foundation): 霍英东教育基金会第十七届高等院校青年教师基金项目“中国人口负增长全要素预测与政策应对”(项目编号:171081)的资助
作者(Author): 倪晨旭,李民,潘伟祥,王震
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- (1)为了进行主成分分析法,需要将抑郁风险等负向指标转化为正向指标,表1报告的是各指标原始水平值,以便于直观描述。 (2)具体参见复旦大学人口与发展政策研究中心2019年发布的智库报告《中国人口发展态势与老龄社会应对》。