Identifying Characteristics Associated with the Concentration and Persistence of Medical Expenses among Middle-Aged and Elderly Adults: Findings from the China Health and Retirement Longitudinal Survey

被引:1
|
作者
Jiang, Luyan [1 ]
Qiu, Qianqian [1 ]
Zhu, Lin [1 ]
Wang, Zhonghua [1 ,2 ,3 ]
机构
[1] Nanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
[2] Nanjing Med Univ, Publ Hlth Policy & Management Innovat Res Grp, Nanjing 211166, Peoples R China
[3] Nanjing Med Univ, Ctr Global Hlth, Nanjing 211166, Peoples R China
关键词
medical expenditures; concentration; persistence; vulnerable groups; China; HIGH-COST PATIENTS; CARE COSTS; SHORT-TERM; EXPENDITURES; BENEFICIARIES; PREVALENCE; USERS;
D O I
10.3390/ijerph191912843
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Medical expenses, especially among middle-aged and elderly people, have increased in China over recent decades. However, few studies have analyzed the concentration or persistence of medical expenses among Chinese residents or vulnerable groups with longitudinal survey data. Based on the data of CHARLS (China Health and Retirement Longitudinal Study), this study sought to identify characteristics associated with the concentration and persistence of medical expenses among Chinese middle-aged and elderly adults and to help alleviate medical spending and the operational risk of social medical insurance. Concentration was measured using the cumulative percentages of ranked annual medical expenses and descriptive statistics were used to define the characteristics of individuals with high medical expenses. The persistence of medical expenses and associated factors were estimated using transfer rate calculations and Heckman selection modeling. The results show that total medical expenses were concentrated among a few adults and the concentration increased over time. People in the high medical expense group were more likely to be older, live in urban areas, be less wealthy, have chronic diseases, and attend higher-ranking medical institutions. Lagged medical expenses had a persistent positive effect on current medical expenses and the effect of a one-period lag was strongest. Individuals with chronic diseases during the lagged period had a higher likelihood of experiencing persistent medical expenses. Policy efforts should focus on preventive management, more efficient care systems, improvement of serious illness insurance level, and strengthening the persistent protection effect of social medical insurance to reduce the high medical financial risk and long-term financial healthcare burden in China.
引用
收藏
页数:18
相关论文
共 50 条
  • [1] Smoking and Cognitive Function Among Middle-Aged Adults in China Findings From the China Health and Retirement Longitudinal Study Baseline Survey
    Ge, Song
    Tang, Xianping
    Wei, Zhe
    Dune, Linda
    Liu, Tingting
    Li, Junxin
    Li, Changwei
    JOURNAL OF ADDICTIONS NURSING, 2020, 31 (03) : E5 - E12
  • [2] SOCIODEMOGRAPHIC ROLE IN DEPRESSION PREVALENCE AMONG MIDDLE-AGED AND ELDERLY IN CHINA: FINDINGS FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
    Ding Gangqiang
    Li Yaru
    Zhang Ronghua
    ANNALS OF NUTRITION AND METABOLISM, 2017, 71 : 1028 - 1028
  • [3] Prevalence, correlates and outcomes of multimorbidity among the middle-aged and elderly: Findings from the China Health and Retirement Longitudinal Study
    Zhang, Yuxia
    Zhou, Liang
    Liu, Siyuan
    Qiao, Yanan
    Wu, Ying
    Ke, Chaofu
    Shen, Yueping
    ARCHIVES OF GERONTOLOGY AND GERIATRICS, 2020, 90
  • [4] Alcohol Use and Cognitive Functioning Among Middle-Aged and Older Adults in China: Findings of the China Health and Retirement Longitudinal Study Baseline Survey
    Ge, Song
    Wei, Zhe
    Liu, Tingting
    Wang, Jinjiao
    Li, Hongjin
    Feng, Juan
    Li, Changwei
    ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, 2018, 42 (10) : 2054 - 2060
  • [5] Association between sarcopenia and multimorbidity among middle-aged and older adults in China: Findings from the China Health and Retirement Longitudinal Study
    Deng, Mingming
    Lu, Ye
    Li, Xuelian
    Zhou, Xiaoming
    Hou, Gang
    EXPERIMENTAL GERONTOLOGY, 2024, 185
  • [6] Impact of social participation on health among middle-aged and elderly adults: evidence from longitudinal survey data in China
    Ma, Xinxin
    Piao, Xiangdan
    Oshio, Takashi
    BMC PUBLIC HEALTH, 2020, 20 (01)
  • [7] Medication of diabetes in middle-aged and elderly: Survey data from the china health and retirement longitudinal study (CHARLS)
    Liu, Lili
    Wang, Shengfeng
    Zhan, Siyan
    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2020, 29 : 227 - 228
  • [8] Impact of social participation on health among middle-aged and elderly adults: evidence from longitudinal survey data in China
    Xinxin Ma
    Xiangdan Piao
    Takashi Oshio
    BMC Public Health, 20
  • [9] Socioeconomic determinants of out-of-pocket pharmaceutical expenditure among middle-aged and elderly adults based on the China Health and Retirement Longitudinal Survey
    Du, Jinglin
    Yang, Xue
    Chen, Mingsheng
    Wang, Zhonghua
    BMJ OPEN, 2019, 9 (07):
  • [10] Alcohol consumption and associated factors among middle-aged and older adults: results from China Health and Retirement Longitudinal Study
    Wang, Qianqian
    Zhang, Yanzhuo
    Wu, Chengai
    BMC PUBLIC HEALTH, 2022, 22 (01)