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
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作者:
Jiang, Luyan
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机构:
Nanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R ChinaNanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
Jiang, Luyan
[1
]
Qiu, Qianqian
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Nanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R ChinaNanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
Qiu, Qianqian
[1
]
Zhu, Lin
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Nanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R ChinaNanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
Zhu, Lin
[1
]
Wang, Zhonghua
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机构:
Nanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
Nanjing Med Univ, Publ Hlth Policy & Management Innovat Res Grp, Nanjing 211166, Peoples R China
Nanjing Med Univ, Ctr Global Hlth, Nanjing 211166, Peoples R ChinaNanjing Med Univ, Sch Hlth Policy & Management, Nanjing 211166, Peoples R China
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
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.
机构:
Renmin Univ China, Sch Sociol & Populat Studies, Dept Social Work & Social Policy, Beijing, Peoples R ChinaRenmin Univ China, Sch Sociol & Populat Studies, Dept Social Work & Social Policy, Beijing, Peoples R China
Lu, Nan
Wu, Bei
论文数: 0引用数: 0
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机构:
NYU, Rory Meyers Coll Nursing, New York, NY 10013 USA
NYU, NYU Aging Incubator, New York, NY 10013 USARenmin Univ China, Sch Sociol & Populat Studies, Dept Social Work & Social Policy, Beijing, Peoples R China
Wu, Bei
Jiang, Nan
论文数: 0引用数: 0
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机构:
Natl Univ Singapore, Fac Arts & Social Sci, Dept Social Work, Singapore, SingaporeRenmin Univ China, Sch Sociol & Populat Studies, Dept Social Work & Social Policy, Beijing, Peoples R China
Jiang, Nan
Dong, Tingyue
论文数: 0引用数: 0
h-index: 0
机构:
Renmin Univ China, Sch Sociol & Populat Studies, Inst Gerontol, Beijing, Peoples R ChinaRenmin Univ China, Sch Sociol & Populat Studies, Dept Social Work & Social Policy, Beijing, Peoples R China
机构:
Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, 38 Xueyuan Rd, Beijing 100191, Peoples R China
Peking Univ Third Hosp, Res Ctr Clin Epidemiol, Beijing, Peoples R China
Peking Univ, Ctr Intelligent Publ Hlth, Inst Artificial Intelligence, Beijing, Peoples R ChinaPeking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, 38 Xueyuan Rd, Beijing 100191, Peoples R China
Zhan, Siyan
Song, Yongfeng
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机构:
Shandong First Med Univ, Shandong Prov Hosp, Dept Endocrinol, Jinan, Peoples R China
Shandong First Med Univ, Shandong Inst Endocrine & Metab Dis, Jinan, Peoples R ChinaPeking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, 38 Xueyuan Rd, Beijing 100191, Peoples R China
机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
Chen, Chaolei
Ou, Yanqiu
论文数: 0引用数: 0
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机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
Ou, Yanqiu
Cai, Anping
论文数: 0引用数: 0
h-index: 0
机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
Cai, Anping
Huang, Yuqing
论文数: 0引用数: 0
h-index: 0
机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
Huang, Yuqing
Feng, Yingqing
论文数: 0引用数: 0
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机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou 510080, Peoples R China
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
Feng, Yingqing
Nie, Zhiqiang
论文数: 0引用数: 0
h-index: 0
机构:
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent,, Guangzhou 510080, Peoples R China
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Global Hlth Res Ctr, Guangzhou 510080, Peoples R China
Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R ChinaSouthern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Cardiovasc Inst, Guangdong Acad Med Sci, Guangzhou 510080, Peoples R China
机构:
Guangdong Second Prov Gen Hosp, Ctr Clin Epidemiol & Methodol CCEM, Guangzhou, Peoples R ChinaGuangdong Second Prov Gen Hosp, Ctr Clin Epidemiol & Methodol CCEM, Guangzhou, Peoples R China
Wang, X.
Li, G.
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机构:
Guangdong Second Prov Gen Hosp, Ctr Clin Epidemiol & Methodol CCEM, Guangzhou, Peoples R ChinaGuangdong Second Prov Gen Hosp, Ctr Clin Epidemiol & Methodol CCEM, Guangzhou, Peoples R China
机构:
Jiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi 214122, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi Sch Med, 1800 Lihu Rd, Wuxi 214122, Jiangsu, Peoples R ChinaJiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Zheng, Xiaowei
Jiang, Minglan
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机构:
Jiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi 214122, Jiangsu, Peoples R ChinaJiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Jiang, Minglan
Ren, Xiao
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机构:
Jiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi 214122, Jiangsu, Peoples R ChinaJiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Ren, Xiao
Han, Longyang
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机构:
Jiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi 214122, Jiangsu, Peoples R ChinaJiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China
Han, Longyang
Shen, Suwen
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机构:
Wuxi Municipal Ctr Dis Control & Prevent, Wuxi 214023, Jiangsu, Peoples R China
Jiangnan Univ, Dept Publ Hlth & Prevent Med, Wuxi 214122, Jiangsu, Peoples R ChinaJiangnan Univ, Publ Hlth Res Ctr, Wuxi 214122, Jiangsu, Peoples R China