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推进医养结合是优化老年健康和养老服务供给的重要举措。基于中国健康与养老追踪调查(CHARLS)2011—2020五期面板数据，采用PSM-DID模型，实证考察医养结合政策试点对老年人心理健康的影响效应。研究发现：(1)医养结合政策试点有利于缓解老年人抑郁情绪，提升精神状态及情景记忆，研究结论经稳健性检验、安慰剂检验后依然成立；(2)政策试点对低龄、女性、无配偶及农村老年人心理健康的影响效应更高；(3)政策试点通过降低老年人医疗费用、增加子女精神慰藉及参加社交活动进而提升心理健康。基于此，应进一步扩大医养结合政策试点范围，针对不同特征的老年群体精准施策，关注医养结合在提高老年人心理健康与韧性方面的积极作用。
Abstract：Promoting the integration of medical and elderly care services is a crucial measure to optimize the supply of health and elderly care services for the older adults in China. Based on the five-phase panel data from 2011 to 2020 of the China Health and Retirement Longitudinal Study(CHARLS), the PSM-DID model is adopted to empirically examine the impact of the pilot implementation of the integrated medical and elderly care policy on the mental health of the older adults. The findings are as follows:(1) The pilot implementation of the integrated medical and elderly care policy is conducive to alleviating the depressive emotions of the older adults, improving their mental state and episodic memory. The research conclusions still hold after robustness tests and placebo tests.(2) This integrated medical and elderly care policy has a greater impact on the mental health of the younger-aged, female, unmarried(without a spouse) and rural older adults.(3) This integrated medical and elderly care policy improves the mental health of the older adults by reducing their medical expenses, increasing the spiritual comfort from their children and their participation in social activities. Based on these findings, the scope of the pilot implementation of the integrated medical and elderly care policy should be further expanded, precise policies should be formulated for different groups of the older adults with distinct characteristics, and attention should be paid to the positive role of the integrated medical and elderly care policy in enhancing the mental health and resilience of the older adults.
① 民政部：《2014年社会服务发展统计公报》,(2015-06-12)[2025-06-11].https://www.gov.cn/xinwen/2015-06/12/content_2878622.htm;国家统计局：《2024年我国60岁以上人口首次突破3亿人》(2025-01-17)[2025-06-11].http://laoling.cctv.com/2025/01/17/ARTI1YQU2WRMlO75bKSmmyLY250117.shtml.
② 乔晓春：《中国人口老龄化的过去、现在和未来》,载《社会政策研究》2024年第1期。
③ Wang L:The Impact of Long-term Care Insurance Pilot on the Mental Health of Older Adults:Quasi-experimental Evidence from China,SSM-Population Health.25(101632),2024.
④ 上海政协：《老人心理健康问题亟待重视：情绪低落、精力减退、失眠焦虑、食欲减退》,(2024-03-03)[2025-05-31].https://www.shszx.gov.cn/shzx/mtsd/content/6b412577-96c3-4fb8-9fc7-e3b19b944bd2.html.
(1)中华人民共和国中央人民政府:《第一批国家级医养结合试点单位名单公布》,(2016-06-22)[2025-05-31].https://www.gov.cn/xinwen/2016-06/22/content_5084357.htm.
(2)中华人民共和国中央人民政府:《关于确定第二批国家级医养结合试点单位的通知》,(2016-09-23)[2025-05-31].https://www.gov.cn/xinwen/2016-09/23/content_5110943.htm.
(3)陈飞,陈琳:《从老龄健康视角评估医养结合试点政策》,载《经济学动态》2023年第10期。
(4)新华网:《全国医养结合机构床位总数达200万张》,[2024-05-16](2025-02-24).https://www.news.cn/politics/20240516/178348184aa2444cbdbd6303c1d76e7e/c.html.
(5)陈岩,杨翠迎:《医养结合与老年健康管理服务利用——来自医养结合试点城市的经验证据》,载《财经研究》2023年第12期;郭诗怡,倪晨旭,李民,等:《医养结合与老年消费——理论与机制》,载《人口与经济》2024年第2期。
(6)Grossman M:On the Concept of Health Capital and the Demand for Health,Journal of Political Economy,80(2),1972.
(7)李运华,冯玉莹:《健康老龄化视域下“医养结合嵌入式”养老服务的质量评价研究》,载《云南民族大学学报(哲学社会科学版)》2024年第4期。
(8)Sabharwal M,Kiel D L,Hijal-Moghrabi I:Best Practices in Local Government Wellness Programs:The Benefits of Organizational Investment and Performance Monitoring,Review of Public Personnel Administration,39(1),2019.
(9)N?ss G,Kirkevold M,Hammer W,et al.:Nursing Care Needs and Services Utilized by Home-Dwelling Elderly with Complex health Problems:Observational Study,BMC Health Services Research,17(645),2017.
(10)杨莉:《医养结合的运营模式探究——以武汉市“互联网+居家养老为例”》,载《学习与实践》2019年第11期。
(11)Ding K R,Wang S B,Xu W Q,et al.:Low Mental Health Literacy and Its Association with Depression,Anxiety and Poor Sleep Quality in Chinese Elderly,Asia-Pacific Psychiatry,14(4),2022;Piper S E,Bailey P E,Lam L T,et al.:Predictors of Mental Health Literacy in Older People,Archives of Gerontology and Geriatrics,79,2018;Tian Y,Fan L,Zhou M,Du W:Impact of Long-Term Care Insurance on Health Inequality in Older Adults in China Based on the Concentration Index Approach,International Health,16(1),2024.
(12)孙鹃娟,孙可心:《子代支持和社区环境对老年人心理健康的影响》,载《人口与发展》2024年第5期。
(13)汪连杰:《促进还是抑制:隔代照料对中老年人身心健康的影响》,载《云南民族大学学报(哲学社会科学版)》2022年第4期。
(14)王晓峰,王坦:《居住方式、居住环境对老年人心理健康的影响——基于自动化机器学习的分析》,载《人口研究》2024年第5期。
(15)周钦,蒋炜歌,郭昕:《社会保险对农村居民心理健康的影响——基于CHARLS数据的实证研究》,载《中国经济问题》2018年第5期。
(16)丁志宏:《社会参与对农村高龄老人健康的影响研究》,载《兰州学刊》2018年第12期。
(17)Guo J,Ling W:The Relationship Between the Mental Health Status and Social Support of the Lonely Elderly with Government Participation in the Internet Context,Front Public Health,10,2022.
(18)王新军,李红:《家庭护理能改善失能老年人的心理健康吗?——基于CHARLS面板数据的实证研究》,载《山东社会科学》2020年第11期。
(19)陈岩,杨翠迎:《医养结合与老年健康管理服务利用——来自医养结合试点城市的经验证据》,载《财经研究》2023年第12期。
(20)高鹏,杨翠迎,周彩:《医养结合与老年人健康养老》,载《财经研究》2022年第4期。
(21)王晓迪,王力,郭清:《医养护一体化——新型医养结合老年健康管理服务模式的构建与发展趋势》,载《健康研究》2017年第1期。
(22)欧阳宇明,申曙光:《医养结合试点政策缓解了老年人健康不平等吗?》,载《保险研究》2025年第2期。
(23)Kim,E S,Delaney S W,Tay L:Life Satisfaction and Subsequent Physical,Behavioral,and Psychosocial Health in Older Adults,The Milbank quarterly,99(1),2021.
(24)Wang L:The Impact of Long-term Care Insurance Pilot on the Mental Health of Older Adults:Quasi-Experimental Evidence from China,SSM-population Health,25(101632),2024.
(25)熊雅婕,齐亚强:《生命历程中的性别化社会角色与心理健康》,载《中国人口科学》2023年第5期。
(26)Xue Y,Lu J,Zheng X,et al.:The Relationship Between Socioeconomic Status and Depression Among the Older Adults:The Mediating Role of Health Promoting Lifestyle,Journal of Affective Disorders,285,2021.
(27)温忠麟,叶宝娟:《中介效应分析:方法和模型发展》,载《心理科学进展》2014年第5期。
基本信息:
DOI：10.13727/j.cnki.53-1191/c.20250627.001
中图分类号:B844.4;D669.6;R197.1
引用信息:
[1]汪连杰.医养结合政策试点与老年人心理健康：作用机制与经验证据[J].云南民族大学学报(哲学社会科学版),2025,42(04):72-82.DOI:10.13727/j.cnki.53-1191/c.20250627.001.
基金信息:
国家社会科学基金项目“老年人数字社会融入的行为测度、障碍识别与精细化治理路径研究”(24CSH113)阶段成果
2025-06-27
2025-06-27
2025-06-27