The association between family doctor contract services and the health of middle-aged and older people in China: an instrumental variables analysis.
Sci Rep
; 14(1): 16229, 2024 07 14.
Article
em En
| MEDLINE
| ID: mdl-39004624
ABSTRACT
Previous research on the association between Family Doctor Contract Services (FDCS) and health has only considered a single indicator of health and has not considered the endogeneity of independent variables. This study aimed to evaluate the association from a multidimensional perspective of the health of middle-aged and older people using the instrumental variables method and determine the underlying mechanisms. Using data from the 2018 China Health and Retirement Longitudinal Study surveys, a total of 19,438 sample was obtained. Health was measured by health related-quality of life (HR-QoL), subjective well-being, and cognitive function. The instrumental variables method was used to estimate the association. Mediation analysis was employed to analyze the underlying mechanisms. The results of the instrumental variables method showed a correlation between FDCS and health, such as HR-QoL (η = 33.714, p < 0.01), subjective well-being (η = 1.106, p < 0.05), and cognitive function (η = 4.133, p < 0.05). However, we found no evidence that FDCS improved physical health. We also identified reduced utilization of healthcare services and increased social activities as mediators of the effect of FDCS on health. The Chinese government should improve incentive-based initiatives to improve the quality of FDCS. Moreover, more attention needs to be paid to the multidimensional health of middle-aged and older people, especially vulnerable groups, such as older individuals and those in rural areas.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Serviços Contratados
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Sci Rep
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China