Preventative care utilization and associated health‐related measurements among older adults following the 2009 health reform in China

Abstract

Summary Purpose It is unclear if older adults' preventive health care utilization is associated with better health in China, as the elderly population and prevalence of chronic disease have escalated. Methods Applying the Donabedian's model for evaluating quality of health care, we analyzed data from the 2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey with 5304 older adults 65 years old and above. The study used propensity score matching to decrease selection bias on preventive care utilization. Preventive care utilization was defined as the use of annual physical examination at least once a year among older adults. Three ordered logistic regression models were performed to evaluate preventive care utilization and three health‐related measurements of current health status, overall health status improvement in the past 12 months, and life satisfaction, controlling for socioeconomic, demographic, and biological factors. Results Older adults who used preventive care reported better health status, overall health status improvement in the past 12 months, and life satisfaction (adjusted odds ratios [AORs] = 1.24, 1.20, 1.30, respectively; all Ps < 0.01), compared with participants who did not use preventive care. Conclusion The research findings suggest that the Chinese central government should continue to enhance the role of preventive care services with further reforms in order to improve older adults' health and life conditions.

Is preventive care utilization associated with lower outpatient and inpatient health‐care expenses among Chinese older adults? A longitudinal analysis

“…Similar circumstances are evident in China, with 7% utilization rate of preventive care services among adults . Thus, with the growing burden of noncommunicable disease in China, the Chinese government should enhance the role of preventive care services with further health reforms, given that benefits of preventive care utilization have been observed . Besides, preventive care services are effective in reducing deaths in the United States, especially among older adults …”

“…The somewhat paradoxical finding that preventive care utilization was not associated with lower outpatient and inpatient health‐care expenses might suggest that older adults who used preventive care services reported better health‐related measurements in China, given that they accessed more health‐care services than their peers who did not access preventive care services. This is based on Evans and Stoddart's observation that healthier individuals have more opportunities for health‐care seeking .…”

“…Chinese adults with lower levels of education and lower household income experience higher barriers to preventive care utilization . The effectiveness of preventive care on health has been demonstrated by Lee and colleagues, who observed that older adults who used preventive care services reported better health‐related outcomes than those who did not use such services. Despite these outcomes, it remains unclear whether preventive care utilization is associated with less total spending on outpatient and inpatient health‐care services among older adults.…”

Living Arrangements and Sleep-Related Outcomes Among Older Adults in China

“…When family members do not live with older adults, the older adults may not have sufficient financial resources and related welfare to maintain good quality of life. In one case, preventative care utilization is strongly associated with better life satisfaction among Chinese older adults (Lee, Chang, & Liu, 2019), but household income is a strong factor accounting to the preventative care utilization in general (Liu et al., 2016). Accordingly, the Chinese central government should promote living arrangements with family members or residential support from family.…”

The association mechanism between social network types and health‐related behaviours among the elderly in rural Hubei Province, China

“…In addition to significant medication adherence issues, other medication behaviours of the elderly (e.g., self‐medication and antibiotic abuse) are also troubling 21 . Likewise, due to lack of income sources, low levels of education and the uneven distribution of medical resources, the rural elderly display relatively low levels of health‐seeking and preventive care behaviour, 22 , 23 which will affect their health 24 . For these important reasons, this study focuses on the medication, health‐seeking and preventive care behaviours of the elderly in rural areas.…”