IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i15p6465-d1204471.html
   My bibliography  Save this article

Out-of-Pocket Health Expenditures Associated with Chronic Health Conditions and Disability in China

Author

Listed:
  • Jingyi Gao

    (Department of Economics, Fordham University, Bronx, NY 10458, USA)

  • Hoolda Kim

    (College of Business and Economics, Fayetteville State University, Fayetteville, NC 28301, USA)

  • Sophie Mitra

    (Department of Economics, Fordham University, Bronx, NY 10458, USA)

Abstract

The objective of this study is to estimate the extra costs of living associated with chronic health conditions and disabilities in China. Leveraging the 2018 China Health and Retirement Longitudinal Study involving 13,530 respondents aged 50 and over, we apply both an ordinary least squares linear regression model and a logistic model to analyze the correlation between medical out-of-pocket expenditures (OOPEs) and chronic health conditions, as well as disabilities measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) limitations. This paper bridges the gap in the literature on OOPEs and their association with disabilities and chronic health conditions, respectively. We find that ADL limitations, IADL limitations, and chronic health conditions are consistently associated with higher OOPEs. The odds that older persons with disabilities and chronic health conditions incur OOPEs are two to three times higher than for persons without disabilities and chronic health conditions, respectively. Persons with disabilities and chronic health conditions have the highest OOPEs. The findings suggest that more policy and research attention is necessary to improve the financial protection of those with chronic health conditions and disabilities, including through access to comprehensive health insurance coverage.

Suggested Citation

  • Jingyi Gao & Hoolda Kim & Sophie Mitra, 2023. "Out-of-Pocket Health Expenditures Associated with Chronic Health Conditions and Disability in China," IJERPH, MDPI, vol. 20(15), pages 1-12, July.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:15:p:6465-:d:1204471
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/15/6465/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/20/15/6465/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    2. Michael Palmer & Jenny Williams & Barbara McPake, 2019. "Standard of Living and Disability in Cambodia," Journal of Development Studies, Taylor & Francis Journals, vol. 55(11), pages 2382-2402, November.
    3. Eric French & Elaine Kelly & Sean Fahle & Kathleen McGarry & Jonathan Skinner, 2016. "Out‐of‐Pocket Medical Expenditures in the United States: Evidence from the Health and Retirement Study," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 785-819, September.
    4. Mitra, Sophie & Posarac, Aleksandra & Vick, Brandon, 2013. "Disability and Poverty in Developing Countries: A Multidimensional Study," World Development, Elsevier, vol. 41(C), pages 1-18.
    5. Peng Tian & Gengyuan Wang & Yaping Liu & Juan Zhou & Maria Alessandra Ragusa, 2021. "Understanding Disabilities among the Elderly in China: Important Factors, Current Situation, and Future Perspective," Discrete Dynamics in Nature and Society, Hindawi, vol. 2021, pages 1-10, March.
    6. Liem Nguyen & John Tayu Lee & Emily S. G. Hulse & Minh Van Hoang & Giang Bao Kim & Duong Bach Le, 2021. "Health Service Utilization and Out-of-Pocket Expenditure Associated with the Continuum of Disability in Vietnam," IJERPH, MDPI, vol. 18(11), pages 1-11, May.
    7. Jette, Alan M., 1994. "How measurement techniques influence estimates of disability in older populations," Social Science & Medicine, Elsevier, vol. 38(7), pages 937-942, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mani, Subha & Mitra, Sophie & Sambamoorthi, Usha, 2018. "Dynamics in health and employment: Evidence from Indonesia," World Development, Elsevier, vol. 104(C), pages 297-309.
    2. Takasaki, Yoshito, 2020. "Impacts of disability on poverty: Quasi-experimental evidence from landmine amputees in Cambodia," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 85-107.
    3. Sophie Mitra & Michael Palmer & Daniel Mont & Nora Groce, 2016. "Can Households Cope with Health Shocks in Vietnam?," Health Economics, John Wiley & Sons, Ltd., vol. 25(7), pages 888-907, July.
    4. Ullmann, Heidi & Cecchini, Simone & Atuesta, Bernardo & Rubio García, Mónica, 2021. "Non-contributory cash transfers: An instrument to promote the rights and well-being of children with disabilities in Latin America and the Caribbean," Documentos de Proyectos 46747, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    5. Daniel Mont & Zachary Morris & Mercoledi Nasiir & Nanette Goodman, 2022. "Estimating Households’ Expenditures on Disability in Africa: The Uses and Limitations of the Standard of Living Method," IJERPH, MDPI, vol. 19(23), pages 1-17, December.
    6. Derek Asuman & Charles Godfred Ackah & Frank Agyire-Tettey, 2021. "Disability and Household Welfare in Ghana: Costs and Correlates," Journal of Family and Economic Issues, Springer, vol. 42(4), pages 633-649, December.
    7. Lena Morgon Banks & Shaffa Hameed & Sofoora Kawsar Usman & Hannah Kuper, 2020. "No One Left Behind? Comparing Poverty and Deprivation between People with and without Disabilities in the Maldives," Sustainability, MDPI, vol. 12(5), pages 1-13, March.
    8. Mizunoya, Suguru & Mitra, Sophie & Yamasaki, Izumi, 2018. "Disability and school attendance in 15 low- and middle-income countries," World Development, Elsevier, vol. 104(C), pages 388-403.
    9. Thomas J. Kniesner & James P. Ziliak, 2002. "Tax Reform and Automatic Stabilization," American Economic Review, American Economic Association, vol. 92(3), pages 590-612, June.
    10. Bratti, Massimiliano & Mendola, Mariapia, 2014. "Parental health and child schooling," Journal of Health Economics, Elsevier, vol. 35(C), pages 94-108.
    11. Aouad, Marion, 2021. "An Examination of the Intracorrelation of Family Health Insurance," IZA Discussion Papers 14541, Institute of Labor Economics (IZA).
    12. LaFave, Daniel & Thomas, Duncan, 2017. "Extended families and child well-being," Journal of Development Economics, Elsevier, vol. 126(C), pages 52-65.
    13. Manoj K. Pandey, 2013. "Elderly's Health Shocks and Household's Ex-ante Poverty in India," ASARC Working Papers 2013-01, The Australian National University, Australia South Asia Research Centre.
    14. repec:eid:wpaper:3/09 is not listed on IDEAS
    15. Raymond Lang & Marguerite Schneider & Maria Kett & Ellie Cole & Nora Groce, 2019. "Policy development: An analysis of disability inclusion in a selection of African Union policies," Development Policy Review, Overseas Development Institute, vol. 37(2), pages 155-175, March.
    16. Emily Lewis & Sophie Mitra & Jaclyn Yap, 2022. "Do Disability Inequalities Grow with Development? Evidence from 40 Countries," Sustainability, MDPI, vol. 14(9), pages 1-13, April.
    17. Sun, Ang & Yao, Yang, 2010. "Health shocks and children's school attainments in rural China," Economics of Education Review, Elsevier, vol. 29(3), pages 375-382, June.
    18. Rebecca L. Thornton & Laurel E. Hatt & Erica M. Field & Mursaleena Islam & Freddy Solís Diaz & Martha Azucena González, 2010. "Social security health insurance for the informal sector in Nicaragua: a randomized evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 181-206, September.
    19. Junhao Liu & Anita Mukherjee, 2021. "Medicaid and long‐term care: The effects of penalizing strategic asset transfers," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 88(1), pages 53-77, March.
    20. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
    21. Pengju Zhao & Ke Li & Peter C. Coyte, 2023. "The impact of non-communicable chronic diseases on the earned income of working age Chinese residents," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-9, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:20:y:2023:i:15:p:6465-:d:1204471. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.