Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors

Abstract

This study aimed to investigate the patterns and predictive factors of healthcare-seeking behavior among older Chinese adults. A sample of 10,914 participants aged ≥60 years from the 2011, 2013 and 2015 China Health and Retirement Longitudinal Study (CHARLS) was included. The bivariate analyses and Heckman selection model was used to identify predictors of healthcare-seeking behavior. Results shows that the utilization rate of outpatient services increased from 21.61% in 2011 to 32.41% in 2015, and that of inpatient services increased from 12.44% to 17.68%. In 2015, 71.93% and 92.18% chose public medical institutions for outpatient and inpatient services, 57.63% and 17.00% chose primary medical institutions. The individuals who were female, were younger, lived in urban, central or western regions, had medical insurance, had poor self-rated health and exhibited activity of daily living (ADL) impairment were more inclined to outpatient and inpatient services. Transportation, medical expenses, the out-of-pocket ratio and the urgency of the disease were associated with provider selection. The universal medical insurance schemes improved health service utilization for the elderly population but had little impact on the choice of medical institutions. The older adults preferred public institutions to private institutions, preferred primary institutions for outpatient care, and higher-level hospitals for hospitalization.

How smart senior care can achieve value co-creation: Evidence from China

“…(A, Location 12) Enterprises achieve the integration of community services and heterogeneous resources, both public and commercial services, through intelligent online platforms (37). Medical institutions or care institutions receive support and guidance from the government and social organizations to provide higher-quality services (38). Such services are provided to the elderly with disabilities, living alone, chronic diseases, and poverty.…”

Patient preferences and attitudes towards first choice medical services in Shenzhen, China: a cross-sectional study

“…The behaviour of consuming medical service involves a series of decision-making processes governed by many factors. In addition to whether residents themselves perceive a need for health services, the choice is also associated with their income level, socioeconomic status, health security, transportation convenience, risk habits, health awareness, and the type and quality of services provided by health facilities 24. Health-seeking behaviour,20–22 defined as the actions taken by individuals who perceive that they have an illness to obtain a suitable remedy,23 occurs only if an individual indeed uses medical resources.…”

“…The influence of income on medical preferences may involve various factors including socioeconomic status, income and environment. Generally, a positive correlation exists between income and healthcare use 24. Wealthy individuals are less likely to underuse healthcare resources; instead, they spend more money and time on healthcare, whereas individuals with lower income face greater barriers to accessing adequate healthcare 43.…”

“…Generally, a positive correlation exists between income and healthcare use. 24 Wealthy individuals are less likely to underuse healthcare resources; instead, they spend more money and time on healthcare, whereas individuals with lower income face greater barriers to accessing adequate healthcare. 43 A study from Finland has also indicated that retirees over the age of 60 or individuals without formal employment have relatively greater difficulty in accessing medical help or even may not seek treatment because of their lower incomes.…”

Temperature might increase the hospital admission risk for rheumatoid arthritis patients in Anqing, China: a time-series study

“…The other opposite direction is that RA patients aged ≥ 65 who have the need to go to the hospital, but actually don’t go for various reasons. High medical costs may prevent the elderly who cannot afford treatment (Zeng et al 2021 ). They visit the hospital only when the pain becomes unbearable.…”