IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0064589.html
   My bibliography  Save this article

Access to Healthcare and Medical Expenditure for the Middle-Aged and Elderly: Observations from China

Author

Listed:
  • Yan Jiang
  • Yu Wang
  • Le Zhang
  • Yang Li
  • Xiaojun Wang
  • Shuangge Ma

Abstract

Background: In the evaluation of a healthcare system, it is of interest to identify factors associated with the usage of different healthcare facilities and with different levels of medical expenditure. Methods: A survey was conducted in January and February of 2012 in China. It focused on the middle-aged and elderly with age of 45 and above. A total of 2,093 people from 1,152 households were surveyed. Results: For inpatient treatment, the probability of using grade III hospitals, which had the highest level of care, was positively associated with age, being married, living in urban areas, and having higher income. For outpatient treatment, the probability of using grade III hospitals was positively associated with age, being married, working in enterprises, living in urban areas, living in central and western regions, and having higher income, and negatively associated with being farmers. The total and out-of-pocket (OOP) medical expenses were analyzed separately. It was found that the expense level was associated with age, education, occupation, living in urban areas, type of hospital used, insurance being used, and per capita income. Conclusion: The access to healthcare and level of medical expenditure were found as associated with demographic characteristics. In addition, differences between areas and regions were observed. Such results may be useful for identifying vulnerable population and for tuning future healthcare development policies.

Suggested Citation

  • Yan Jiang & Yu Wang & Le Zhang & Yang Li & Xiaojun Wang & Shuangge Ma, 2013. "Access to Healthcare and Medical Expenditure for the Middle-Aged and Elderly: Observations from China," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-10, May.
    • Handle: RePEc:plo:pone00:0064589
    DOI: 10.1371/journal.pone.0064589
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0064589
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0064589&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0064589?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Xiaoyun Liang & Hong Guo & Chenggang Jin & Xiaoxia Peng & Xiulan Zhang, 2012. "The Effect of New Cooperative Medical Scheme on Health Outcomes and Alleviating Catastrophic Health Expenditure in China: A Systematic Review," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-11, August.
    2. Kuangnan Fang & BenChang Shia & Shuangge Ma, 2012. "Health Insurance Coverage and Impact: A Survey in Three Cities in China," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-8, June.
    3. Nguyen, K.T. & Khuat, O.T.H. & Ma, S. & Pham, D.C. & Khuat, G.T.H. & Ruger, J.P., 2012. "Impact of health insurance on health care treatment and cost in Vietnam: A health capability approach to financial protection," American Journal of Public Health, American Public Health Association, vol. 102(8), pages 1450-1461.
    4. Foster, Andrew D, 1994. "Poverty and Illness in Low-Income Rural Areas," American Economic Review, American Economic Association, vol. 84(2), pages 216-220, May.
    5. Wang, Hong & Zhang, Licheng & Hsiao, William, 2006. "Ill health and its potential influence on household consumptions in rural China," Health Policy, Elsevier, vol. 78(2-3), pages 167-177, October.
    6. Wagstaff, Adam, 2007. "The economic consequences of health shocks: Evidence from Vietnam," Journal of Health Economics, Elsevier, vol. 26(1), pages 82-100, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Zheng Xie & Adrienne N Poon & Zhijun Wu & Weiyan Jian & Kit Yee Chan, 2015. "Is Occupation a Good Predictor of Self-Rated Health in China?," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-18, May.
    2. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
    3. Tao Zhang & Jing Liu & Chaojie Liu, 2019. "Changes in Perceived Accessibility to Healthcare from the Elderly between 2005 and 2014 in China: An Oaxaca–Blinder Decomposition Analysis," IJERPH, MDPI, vol. 16(20), pages 1-12, October.
    4. Zhaorong Gao & Lingzhong Xu & Wenzhe Qin & Jiao Zhang & Jinling Zhou & Fangfang Hu & Zhuang Hong, 2020. "Prevalence and Associated Factors of Self-Treatment among the Elderly—A Comparative Study between Empty and Non-Empty Nesters in Shandong, China," IJERPH, MDPI, vol. 17(21), pages 1-11, October.
    5. Yang Li & Yinjun Zhao & Danhui Yi & Xiaojun Wang & Yan Jiang & Yu Wang & Xinchun Liu & Shuangge Ma, 2017. "Differences exist across insurance schemes in China post-consolidation," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-13, November.
    6. Rui Miao & Xiaohao Xiang & Qi Wu & Zhibin Jiang, 2020. "Evaluation method of medical service system based on DEMATEL and the information entropy: A case study of hypertension diagnosis and treatment in China," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-15, December.

    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. Kuangnan Fang & Yefei Jiang & BenChang Shia & Shuangge Ma, 2012. "Impact of Illness and Medical Expenditure on Household Consumptions: A Survey in Western China," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-8, December.
    2. Jie Song & Hong Ji & Benchang Shia & Shuangge Ma, 2013. "Distribution of Illness and Medical Expenditure: A Survey in Two Villages in Rural Beijing," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-8, April.
    3. Kim Thuy Nguyen & Oanh Thi Hai Khuat & Shuangge Ma & Duc Cuong Pham & Giang Thi Hong Khuat & Jennifer Prah Ruger, 2012. "Effect of Health Expenses on Household Capabilities and Resource Allocation in a Rural Commune in Vietnam," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-11, October.
    4. Nguyen, Kim Thuy & Hai Khuat, Oanh Thi & Ma, Shuangge & Pham, Duc Cuong & Hong Khuat, Giang Thi & Ruger, Jennifer Prah, 2012. "Coping with health care expenses among poor households: Evidence from a rural commune in Vietnam," Social Science & Medicine, Elsevier, vol. 74(5), pages 724-733.
    5. Kim, Younhee & Yang, Bongmin, 2011. "Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea," Health Policy, Elsevier, vol. 100(2), pages 239-246.
    6. Yinjun Zhao & Bowei Kang & Yawen Liu & Yichong Li & Guoqing Shi & Tao Shen & Yong Jiang & Mei Zhang & Maigeng Zhou & Limin Wang, 2014. "Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    7. Runguo Wu & Niying Li & Angelo Ercia, 2020. "The Effects of Private Health Insurance on Universal Health Coverage Objectives in China: A Systematic Literature Review," IJERPH, MDPI, vol. 17(6), pages 1-21, March.
    8. Chaw-Yin Myint & Milena Pavlova & Khin-Ni-Ni Thein & Wim Groot, 2019. "A systematic review of the health-financing mechanisms in the Association of Southeast Asian Nations countries and the People’s Republic of China: Lessons for the move towards universal health coverag," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    9. Christiaensen, Luc & Hoffmann, Vivian & Sarris, Alexander, 2007. "Gauging the welfare effects of shocks in rural Tanzania," Policy Research Working Paper Series 4406, The World Bank.
    10. Yang Li & Yinjun Zhao & Danhui Yi & Xiaojun Wang & Yan Jiang & Yu Wang & Xinchun Liu & Shuangge Ma, 2017. "Differences exist across insurance schemes in China post-consolidation," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-13, November.
    11. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    12. Bratti, Massimiliano & Mendola, Mariapia, 2014. "Parental health and child schooling," Journal of Health Economics, Elsevier, vol. 35(C), pages 94-108.
    13. Richard J. Cebula, 2008. "Small Firm Size and Health Insurance: A Private Enterprise Perspective," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 24(Fall 2008), pages 51-77.
    14. Hu, Shu & Das, Dhiman, 2019. "Quality of life among older adults in China and India: Does productive engagement help?," Social Science & Medicine, Elsevier, vol. 229(C), pages 144-153.
    15. Neelsen, Sven & Limwattananon, Supon & O'Donnell, Owen & van Doorslaer, Eddy, 2019. "Universal health coverage: A (social insurance) job half done?," World Development, Elsevier, vol. 113(C), pages 246-258.
    16. repec:eid:wpaper:3/09 is not listed on IDEAS
    17. Adam Wagstaff & Magnus Lindelow, 2014. "Are Health Shocks Different? Evidence From A Multishock Survey In Laos," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 706-718, June.
    18. Nshakira-Rukundo, Emmanuel & Mussa, Essa Chanie & Gerber, Nicolas & von Braun, Joachim, 2020. "Impact of voluntary community-based health insurance on child stunting: Evidence from rural Uganda," Social Science & Medicine, Elsevier, vol. 245(C).
    19. Belén Sáenz de Miera Juárez, 2017. "The role of public health insurance in protecting against the costs of ill health," WIDER Working Paper Series 003, World Institute for Development Economic Research (UNU-WIDER).
    20. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    21. Sandoval Moreno, Carlos, 2019. "Three essays on poverty measurement and risk protection," Other publications TiSEM 934c114b-7dce-431b-a613-a, Tilburg University, School of Economics and Management.

    More about this item

    Statistics

    Access and download statistics

    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:plo:pone00:0064589. 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: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    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.