广西医科大学学报2025，Vol.42Issue(6)：919-928,10.DOI:10.16190/j.cnki.45-1211/r.2025.06.016
基于机器学习的老年人医疗服务利用影响因素分析
Analysis of factors influencing medical service utilization among older adults based on ma-chine learning
摘要
Abstract
Objective:To investigate the current status and influencing factors of medical service utilization among older adults in integrated care institutions,aiming to provide an empirical basis for optimizing the alloca-tion of medical resources and enhancing health management for older adults.Methods:A cross-sectional survey was conducted from October to December 2024,employing stratified sampling to recruit 395 elderly residents from 10 integrated care institutions in the cities of Nanning,Guilin,and Yulin.The random forest model was used to rank the importance of influencing factors,combined with LASSO regression for variable selection.Signifi-cant variables were subsequently incorporated into a multivariate logistic regression model for analysis.Results:The utilization rates for outpatient and inpatient services were 42.5%and 32.4%,respectively.Multivariate analy-sis revealed that health checkups(OR=2.107,P=0.007)and pain(OR=2.447,P=0.000)were significant promot-ing factors for outpatient service utilization,whereas a travel time to the hospital of＜10 minutes(OR=1.988,P=0.026)significantly increased outpatient utilization.A history of falls(OR=2.822,P=0.000)was a strong influenc-ing factor for inpatient service utilization,while female gender(OR=0.480,P=0.006)was associated with a lower probability for inpatient service utilization.In terms of outpatient service utilization,common family diseases and genetic diseases ranked high in the random forest model,while for inpatient service utilization,a history of falls and education level ranked prominently in the model.Conclusion:Medical service utilization among older adults in integrated care institutions in Guangxi is jointly influenced by health needs,service accessibility,health beliefs,and sociodemographic characteristics.To enhance the efficiency and equity of service utilization,it is recom-mended to strengthen health management,optimize service layout,implement health education,and focus on vul-nerable groups.关键词
医养结合/医疗服务利用/健康需求/健康管理/老年人Key words
integration of elderly care and medical services/medical service utilization/health needs/health management/older adults分类
医药卫生引用本文复制引用
李晓,张无忧,曹俊月,朱晓宇..基于机器学习的老年人医疗服务利用影响因素分析[J].广西医科大学学报,2025,42(6):919-928,10.基金项目
广西高校中青年教师科研基础能力提升项目(No.2024KY0083) （No.2024KY0083）
