Chronic disease and medical spending of Chinese elderly in rural region

Abstract

Objective To determine whether or not chronic disease positively impacts medical costs among the rural elderly in China and to calculate medical expenditure induced by chronic disease between different groups of the rural elderly, as well as provide insight into the factors that affect medical losses induced by chronic disease among different household registration groups and different New Rural Pension Scheme statuses. Design To estimate the share of medical expenses induced by chronic disease, this paper uses a two-part model and a four-part model to analyze the causal effect of chronic disease on medical services, and then uses a counter-factual method to estimate the share of medical expenses. Setting The rapid development of China has changed nearly every aspect of life for the rural elderly. Many are concerned about the increasing prevalence of physical health issues, particularly chronic diseases, among the rural elderly. Nevertheless, there are no articles using nationally representative panel datasets that report differences in the cost of chronic disease between sub-populations. Participants The panel dataset used for this study comes from the China Family Panel Studies (CFPS) data. In this study, we use the CFPS data for the years 2012, 2014 and 2016 to create a panel dataset that includes 2730 rural elderly for three years. Interventions This article reports the representative estimate of medical expenditures attributable to chronic disease among rural elderly in China. On this basis, we estimate per capita medical spending among rural elderly under the condition of logarithmic normal distribution of different parameters between urban and rural or between groups that participate in the New Rural Pension Program and groups that do not. Main Outcome Measures This study indicates that physical health status has a significant impact on both the probability of undergoing medical care and the size of medical expenditures among the rural elderly, and the influence was significant for all patients, including outpatients and inpatients. Results Chronic illness has significant effects on individual medical expenses, and they aggregately contribute to 63.96% of total personal expected medical expenditure. Specifically, the medical spending caused by chronic disease was part of a non-uniform distribution, with the rural, male, older, married, and higher-educated groups spending more money on medical costs induced by chronic disease. Conclusions Examining trends in the prevalence of chronic diseases and evaluating medical spending on chronic diseases can prevent and control potential medical costs among rural elderly, especially for vulnerable groups, which helps to predict future health care needs.

Healthcare costs attributable to noncommunicable diseases: a longitudinal study based on the elderly population in China

“…According to the results of heterogeneity analysis, the chronic healthcare costs of urban seniors are higher than those of rural seniors, which is consistent with previous research ndings [12,48,49]. Due to the relatively lower income, rural elderly has a lower rate of healthcare service consumption.…”

“…Referring to existing studies [12,19,20], we controlled for a number of variables that in uence the utilization and cost of healthcare services for the elderly in the model, including age, gender (male = 0, female = 1), residence (rural = 0, urban = 1), education level (primary and below = 0, middle and above = 1), marital status (other = 0, cohabited = 1), health insurance coverage (no = 0, yes = 1), smoking status (none = 1, quit = 2, still = 3), drinking status (none = 1, quit = 2, still = 3), body mass index (BMI) (underweight = 1, normal weight = 2, overweight = 3, obesity = 4), activities of daily living (ADL), annual household income per capita.…”

The Effects of Social Support and Morbidities on Self-Rated Health among Migrant Elderly Following Children to Jinan, China

“…A number of previous studies have documented the relationship between chronic disease and selfreported health and have consistently shown that chronic diseases have a negative impact on health [39][40][41]. Chronic diseases are a serious threat to the health of the elderly and are a common problem that needs to be addressed globally [42,43]. This study also provides scientific evidence for the promotion of the self-rated health among the MEFC.…”

The status of health promotion lifestyle and its related factors in Shandong Province, China

“…Previous study demonstrated that among older Chinese adults (age ≥ 60 years), the overall prevalence of multimorbidity was up to 87.0% in urban residents [ 13 ], while the proportion was even up to 90% [ 14 ] in rural residents. The medical burden of chronic diseases has become the largest proportion of medical expenses of rural residents in China [ 15 ].…”