【摘要】 目的 探究我国中老年残疾人医疗服务利用及影响因素，为相关部门制定中老年残疾人卫生服务政策提供科学依据。方法 基于安德森卫生服务利用模型，提取中国健康与养老追踪调查(CHARLS)2018年全国抽样调查中的中老年残疾人数据，采用χ~2检验进行单因素分析，应用Logistic回归模型分析中老年残疾人医疗服务利用的影响因素。结果 共纳入2 137名中老年残疾人，门诊服务利用率为20.87%,住院服务利用率为25.55%。受教育水平高、戒烟、慢性病患病数量3个及以上和自评健康为“一般”及以下会减少中老年残疾人门诊服务利用，个人经济收入越高、不参与社交活动对门诊服务利用存在正向影响(P<0.05)。年龄70岁及以上、戒烟、不饮酒、未参保、慢性病患病数量越多和自评健康为“一般”及以下对中老年残疾人住院服务利用存在负向影响(P<0.05)。结论 中老年残疾人医疗服务利用受倾向特征、能力资源、需要因素的共同影响。需针对中老年残疾人的特殊医疗服务需求，合理配置医疗资源、完善社会福利制度、加强健康管理服务，从而提升中老年残疾人医疗资源利用程度。更多还原

【Abstract】 Objective To explore the utilization of medical services for middle-aged and elderly people with disabilities in China and the influencing factors, and to provide scientific basis for the relevant departments to formulate health service policies for them. Methods Based on Anderson’s healthcare utilization behavioral model, the data of middle-aged and elderly disabled people from the CHARLS 2018 National Sample Survey were extracted. The χ~2 test was used for univariate analysis, and the Logistic regression model was applied to analyze the influencing factors for healthcare utilization of middle-aged and elderly disabled people. Results A total of 2,137 middle-aged and elderly persons with disabilities were included in the study. There was a utilization rate of 20.87% for outpatient services and 25.55% for inpatient services. Higher levels of education, smoking cessation, three or more chronic diseases, and self-assessed health as “average” or below reduced the utilization of outpatient services by middle-aged and elderly disabled population, while higher personal financial income and non-participation in social activities had a positive effect on the utilization of outpatient services(P<0.05). An age of 70 and above, smoking cessation, non-alcohol consumption, uninsured status, higher number of chronic diseases, and self-assessed health as “average” and below had a negative impact on the utilization of inpatient services for middle-aged and elderly disabled persons(P<0.05). Conclusions Health care utilization among middle-aged and elderly adults with disabilities is influenced by a combination of predisposing, enabling, and need factors. In response to the special medical service needs of middle-aged and elderly persons with disabilities, it is necessary to rationalize the allocation of health resources, improve the social welfare system and strengthen health management services, so as to improve the utilization rate of health resources for middle-aged and elderly population with disabilities.更多还原