国家十四五规划将人口老龄化问题和居民健康作为两大国家战略重点提出，未来为老年人提供优质医疗服务将是一个重要议题。因此分析老年人医疗服务满意度的影响因素及其城乡作用的差异性，具有一定现实意义。本文基于安德森卫生服务利用模型和Penchansky模型构建中国老年人医疗服务满意度理论框架，运用CHARLS数据，分析中国老年人医疗服务满意度的影响因素及其在城乡之间的作用差异。结果表明农村老年人医疗服务满意度整体高于城市老年人;对于农村老年人,年龄、交通经济成本对医疗服务满意度具有正向影响，教育水平、自付比例、交通时间成本为负向影响，女性和公立医院就医的农村老年人满意度较高；对于城市老年人，受教育水平负向影响医疗服务满意度，基层就医的城市老年人满意度较高。从提高医疗满意度出发，针对影响因素提出对策建议。

In the 14th Five-Year Plan of China, safeguarding people's health and actively responding to population aging are proposed as national strategies. Therefore, improving the quality of medical services for the elderly will be an important issue in the future. Based on the Anderson's Model and Penchansky Model, this paper uses CHARLS data to compare and analyze the medical service satisfaction and its determinants from the perspective of urban and rural differences. The results show that the overall satisfaction of the rural elderly in medical services is higher than that of the urban elderly; For the rural elderly, age and transportation cost have a positive impact on medical service satisfaction, while educated years, self-pay ratio, and transportation time have a negative effect. Females and rural elderly who go to public hospitals have higher satisfaction; For the urban elderly, educated years negatively affects the satisfaction of medical services, and the satisfaction of the urban elderly who seeking primary medical treatment is higher. Starting from improving medical satisfaction, this paper proposes countermeasures and suggestions based the above determinants.

1. 国家自然科学基金项目（面上项目，重点项目，重大项目）（41671124）：居民健康视角下区域经济社会发展对 PM2.5浓度的影响机理与调控研 究，负责人：吕晨；2. 社会科学类一般项目（Y95402CXX2）：居民时空行为特征的PM2.5暴露及空气质量改善支付意愿研究——基于环境公平视角，负责人：吕晨