Hospital Utilization Among Chinese Older Adults: Patterns and Predictors

Chen, Honglin; Chi, Iris; Liu, Ruotong

doi:10.1177/0898264318780546

Cited by 29 publications

(26 citation statements)

References 30 publications

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“…Although most of the earlier research has been centered around Western countries, recent studies have started to examine the drastic urban–rural health disparity in East Asian countries as well . East Asia draws a unique picture compared with the West due to differences in pathways of urbanization.…”

Section: Introductionmentioning

confidence: 99%

“…12 Although most of the earlier research has been centered around Western countries, recent studies have started to examine the drastic urban-rural health disparity in East Asian countries as well. [13][14][15] East Asia draws a unique picture compared with the West due to differences in pathways of urbanization. East Asian countries, especially Korea and China, came out of the Cold War in poverty, but have experienced dynamic economic and infrastructure growth, placing themselves as some of the biggest economies in the world in the 21st century.…”

Section: Introductionmentioning

confidence: 99%

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Urban–rural differences in multimorbidity and associated factors in China and Korea: A population‐based survey study

Kim

Chi

2019

Geriatrics Gerontology Int

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Aim To analyze differences in multimorbidity rates and associated factors between urban and rural regions of Korea and China. Methods Data were drawn from the Gateway to Global Aging Datasets. We describe multimorbidity patterns across rural and urban settings in each of the countries. Multivariate regression was used to identify factors associated with multimorbidity in each of the countries by region. Results In China, 31% of the sample had multimorbidity, with significantly higher proportions in the cities. In Korea, 24% had multimorbidity, with higher proportions in rural areas. However, multivariate analyses showed that rurality was associated with a lower risk of multimorbidity in both countries. Also, although there was significant socioeconomic disparity regarding multimorbidity in both rural and urban China, the disparity was focused around urban areas for Korea. Conclusions Multimorbidity rates and associated socioeconomic factors varied by country and region. The concentration of socioeconomic disparities associated with multimorbidity in urban regions call to attention the vulnerability of “urban poor” in East Asia against chronic conditions. Geriatr Gerontol Int 2019; 19: 1157–1164.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Urban–rural differences in multimorbidity and associated factors in China and Korea: A population‐based survey study

Kim

Chi

2019

Geriatrics Gerontology Int

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“…This population continues to grow while life expectancy is also increasing due to improved living standards and access to health services. Unfortunately though, the gap between supply and demand is widening, and the lack of a primary care system and relatively low salaries for emergency medical physicians appear to have created shortages in emergency medical resources . The knock‐on effect is an increasing number of patients presenting at emergency departments (EDs) where the evident shortage impacts on society.…”

Section: Introductionmentioning

confidence: 99%

“…Unfortunately though, the gap between supply and demand is widening, and the lack of a primary care system and relatively low salaries for emergency medical physicians appear to have created shortages in emergency medical resources. [1][2][3] The knock-on effect is an increasing number of patients presenting at emergency departments (EDs) where the evident shortage impacts on society. EDs in China have long been criticized for overcrowding, long waiting times, low-quality service, and lacking of timely interventions.…”

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confidence: 99%

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Jin

Zhang

Seery

et al. 2019

Health Planning & Management

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Summary The number of private healthcare facilities has rapidly increased since the progressive open market policies, which began in the 1980s; however, little is known about the development of private emergency departments (EDs). This cross‐sectional study was part of the National Control Information System (NCIS) project, which collects data annually from hospitals across China. Emergency services data were extracted and included location, infrastructure, human resources, beds, and number of patients; 4529 hospitals across 31 provinces in mainland China were eventually included, consisting of 988 private and 3541 public EDs. Evidence shows that most private EDs are located in central China, where local economies are relatively developed. Most private EDs (91.6%) are found in secondary hospitals but have significantly fewer beds and smaller workforces compared with public EDs. An imbalance of emergency medical resources was observed across China, and this disparity becomes even more profound in rural hospitals. These findings may initiate collaborative, public‐private partnerships in emergency health services provision and suggest there is a need to offer tax breaks to incentivize investors, but further research is required. We may also need to rethink health insurance policies, which could enable more equitable access to private emergency care. Future planning and health policies must be based upon the strongest available evidence, if we are to address imbalanced health services distribution and growing demand.

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“…To some extent, the inconformity indirectly reflected that the prevalence rate of malignant tumor continuously increased. With the development of economy, the per capita disposable income and health awareness of residents increased so that the residents would go to hospital when they were ill [19,20]. In addition, the unceasing improvement of NRCMS promoted the participation rate increasing which also resulted in the rise of hospital admissions [21,22].…”

Section: Discussionmentioning

confidence: 99%

Trend of disparity between coastland and inland in medical expenditure burden for rural inpatients with malignant tumor in southeast of China from 2007 to 2016

Lin

et al. 2020

BMC Cancer

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Background: New Rural Cooperative Medical Scheme (NRCMS) was developed to improve the health security for rural residents. This study aimed to assess the trend of disparity between coastland and inland in medical expenditure burden for rural inpatients with malignant tumor from 2007 to 2016 under the effect of NRCMS. Methods: The data from medical records of 1,306,895 patients with malignant tumor who had NRCMS in 2932 hospitals was collected. The relative differences [95% confidence intervals (CIs)] between coastland and inland in four medical expense indicators were calculated using generalized linear models to assess the trend of disparity over time. Results: In total, there were 769,484 (58.88%) coastland patients and 537,411 (41.12%) inland patients. Male and patients aged older than 44 years accounted for 56.87 and 80% of 1,306,895 patients, respectively. After adjusting for gender, age, tumor site and hospital level, coastland patients had higher hospitalization expenses which were all medical expenses incurred during the hospitalization, lower reimbursement ratio and ratio of out-of-pocket expenses to disposable income than inland patients in most years. The surgery expenses of coastland patients were lower than those of inland patients in 2016. The relative differences (95% CIs) between coastland and inland in medical expense indicators were moving closer to 1.0 from 2007 to 2010 among patients without surgery, implying that the disparity between two areas significantly narrowed. The range of change was similar between two areas from 2011 to 2016 whether among patients without or with surgery, implying that the disparity did not significantly change. The disparity between coastland and inland depended on the household income situation. For low-income patients, the differences between two areas in medical expense indicators were not statistically significance in most cases and the disparity between two areas did not significantly change over time.

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Hospital Utilization Among Chinese Older Adults: Patterns and Predictors

Abstract: Conclusions regarding how to integrate the complex range of hospital services more effectively and evenly are described. Social services should be developed in response to the hospital services utilization needs of older people.

Cited by 29 publications

References 30 publications

Urban–rural differences in multimorbidity and associated factors in China and Korea: A population‐based survey study

Urban–rural differences in multimorbidity and associated factors in China and Korea: A population‐based survey study

Comparing public and private emergency departments in China: Early evidence from a national healthcare quality survey

Trend of disparity between coastland and inland in medical expenditure burden for rural inpatients with malignant tumor in southeast of China from 2007 to 2016

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