PDF(Pubmed)
Abstract：
Addressing health inequity (HI) for older people is a pivotal global public health concern, as it impedes the process of healthy ageing. The digital health care service reform (DHSR) emerges as a progressive public health approach to enhance the health and well-being of older adults by providing comprehensive and equitable medical services. This study elucidates the association between DHSR and HI for older individuals to augment comprehension of DHSR implementation.
The initiation of the action plan for smart health and eldercare (SHE) in 2017 serves as a quasi-natural experiment. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, a propensity score matching (PSM) method was used to select samples, and a difference-in-differences (DID) regression was used to ascertain the net effect of DHSR on HI for older individuals in China. This methodology mitigates selection bias and segregates the DHSR effect from temporal shifts or other occurrences.
The PSM-DID analysis reveals that DHSR reduced the HI index for older individuals by 0.301 (p < 0.01). Heterogeneity analyses indicate that the effect of DHSR was more pronounced in older males (-0.333, p < 0.01) than females (-0.251, p < 0.05). The impact of DHSR was notably higher for older population in the western (-0.557, p < 0.01) and central regions (-0.318, p < 0.05) compared to the eastern region, where the relationship was statistically non-significant.
The results demonstrate that DHSR plays a vital role in diminishing HI, fostering inclusive growth in public health. The study underscores the imperative of sustained DHSR endeavours and allocating resources to key older demographics to substantially mitigate HI.
The initiation of the action plan for smart health and eldercare (SHE) in 2017 serves as a quasi-natural experiment. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, a propensity score matching (PSM) method was used to select samples, and a difference-in-differences (DID) regression was used to ascertain the net effect of DHSR on HI for older individuals in China. This methodology mitigates selection bias and segregates the DHSR effect from temporal shifts or other occurrences.
The PSM-DID analysis reveals that DHSR reduced the HI index for older individuals by 0.301 (p < 0.01). Heterogeneity analyses indicate that the effect of DHSR was more pronounced in older males (-0.333, p < 0.01) than females (-0.251, p < 0.05). The impact of DHSR was notably higher for older population in the western (-0.557, p < 0.01) and central regions (-0.318, p < 0.05) compared to the eastern region, where the relationship was statistically non-significant.
The results demonstrate that DHSR plays a vital role in diminishing HI, fostering inclusive growth in public health. The study underscores the imperative of sustained DHSR endeavours and allocating resources to key older demographics to substantially mitigate HI.
摘要：
■解决老年人的健康不平等（HI）是一个关键的全球公共卫生问题，因为它阻碍了健康老龄化的进程。数字医疗服务改革（DHSR）是一种进步的公共卫生方法，旨在通过提供全面和公平的医疗服务来增强老年人的健康和福祉。这项研究阐明了老年人DHSR和HI之间的关联，以增强对DHSR实施的理解。
■2017年智能健康和老年保健（SHE）行动计划的启动是一项准自然实验。利用2015年和2018年中国健康与退休纵向研究（CHARLS）的数据，使用倾向得分匹配（PSM）方法选择样本，并使用差异（DID）回归来确定DHSR对中国老年人HI的净影响。这种方法减轻了选择偏差，并将DHSR效应与时间偏移或其他事件隔离。
■PSM-DID分析表明，DHSR将老年人的HI指数降低了0.301（p<0.01）。异质性分析表明，DHSR的影响在老年男性中（-0.333，p<0.01）比女性（-0.251，p<0.05）更为明显。与东部地区相比，DHSR对西部地区（-0.557，p<0.01）和中部地区（-0.318，p<0.05）的老年人口的影响明显更高，其中关系在统计学上不显着。
■结果表明，DHSR在降低HI中起着至关重要的作用，促进公共卫生领域的包容性增长。该研究强调了持续的DHSR努力的必要性，并为关键的旧人口统计数据分配资源，以大幅缓解HI。
■2017年智能健康和老年保健（SHE）行动计划的启动是一项准自然实验。利用2015年和2018年中国健康与退休纵向研究（CHARLS）的数据，使用倾向得分匹配（PSM）方法选择样本，并使用差异（DID）回归来确定DHSR对中国老年人HI的净影响。这种方法减轻了选择偏差，并将DHSR效应与时间偏移或其他事件隔离。
■PSM-DID分析表明，DHSR将老年人的HI指数降低了0.301（p<0.01）。异质性分析表明，DHSR的影响在老年男性中（-0.333，p<0.01）比女性（-0.251，p<0.05）更为明显。与东部地区相比，DHSR对西部地区（-0.557，p<0.01）和中部地区（-0.318，p<0.05）的老年人口的影响明显更高，其中关系在统计学上不显着。
■结果表明，DHSR在降低HI中起着至关重要的作用，促进公共卫生领域的包容性增长。该研究强调了持续的DHSR努力的必要性，并为关键的旧人口统计数据分配资源，以大幅缓解HI。
