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

Author

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  • 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
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    References listed on IDEAS

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    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. 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.
    4. 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.
    5. 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.
    6. 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.
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