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Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013
BACKGROUND: Rapid population ageing in China is increasing the numbers of older people who are likely to require health services in response to higher levels of poor perceived health and chronic diseases. Understanding factors influencing health services use at late life will help to plan for increa...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758158/ https://www.ncbi.nlm.nih.gov/pubmed/26892677 http://dx.doi.org/10.1186/s12913-016-1307-8 |
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author | Gong, Cathy Honge Kendig, Hal He, Xiaojun |
author_facet | Gong, Cathy Honge Kendig, Hal He, Xiaojun |
author_sort | Gong, Cathy Honge |
collection | PubMed |
description | BACKGROUND: Rapid population ageing in China is increasing the numbers of older people who are likely to require health services in response to higher levels of poor perceived health and chronic diseases. Understanding factors influencing health services use at late life will help to plan for increasing needs for health care, reducing inequalities in health services use and releasing severe pressures on a highly variable health care system that has constrained public resources and increasing reliance on health insurance and user payments. METHODS: Drawing on the nationally representative China Health and Retirement Longitudinal Study 2013 data, we apply the Andersen healthcare utilization conceptual model to binary logistic regression multivariate analyses to examine the joint predictors of physical examinations, outpatient and inpatient care among the middle-aged and elderly in China. RESULTS: The multivariate analyses find that both physical examinations and inpatient care rates increase significantly by age when health deteriorates. Females are less likely to use inpatient care. Significant socio-economic variations exist in healthcare utilization. Older people with higher education, communist party membership, urban residence, non-agricultural household registration, better financial situation are more likely to have physical examinations or inpatient care. Factors influencing all three types of health care utilization are household expenditure, losing a partner, having multiple chronic diseases or perceiving poor health. With activities of daily living limitations or pain increases the probability of seeing a doctor while with functional loss increases the rates of having physical examinations, but being the ethnic minorities, no social health insurance, with depression, fair or poor memory could be a barrier to having physical examinations or seeing a doctor, which might delay the early diagnose of severe health problems among these groups. Not drinking, not smoking and regular physical exercises are adaptations after having health problems. CONCLUSIONS: As a rapidly ageing society, in order to address the increasing needs and inequalities in health care utilization, China is facing a massive challenge to reform the current health care system, improve equitable access to health insurance and financial affordability for the most disadvantaged, as well as to provide more health education and information to the general public. |
format | Online Article Text |
id | pubmed-4758158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47581582016-02-19 Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 Gong, Cathy Honge Kendig, Hal He, Xiaojun BMC Health Serv Res Research Article BACKGROUND: Rapid population ageing in China is increasing the numbers of older people who are likely to require health services in response to higher levels of poor perceived health and chronic diseases. Understanding factors influencing health services use at late life will help to plan for increasing needs for health care, reducing inequalities in health services use and releasing severe pressures on a highly variable health care system that has constrained public resources and increasing reliance on health insurance and user payments. METHODS: Drawing on the nationally representative China Health and Retirement Longitudinal Study 2013 data, we apply the Andersen healthcare utilization conceptual model to binary logistic regression multivariate analyses to examine the joint predictors of physical examinations, outpatient and inpatient care among the middle-aged and elderly in China. RESULTS: The multivariate analyses find that both physical examinations and inpatient care rates increase significantly by age when health deteriorates. Females are less likely to use inpatient care. Significant socio-economic variations exist in healthcare utilization. Older people with higher education, communist party membership, urban residence, non-agricultural household registration, better financial situation are more likely to have physical examinations or inpatient care. Factors influencing all three types of health care utilization are household expenditure, losing a partner, having multiple chronic diseases or perceiving poor health. With activities of daily living limitations or pain increases the probability of seeing a doctor while with functional loss increases the rates of having physical examinations, but being the ethnic minorities, no social health insurance, with depression, fair or poor memory could be a barrier to having physical examinations or seeing a doctor, which might delay the early diagnose of severe health problems among these groups. Not drinking, not smoking and regular physical exercises are adaptations after having health problems. CONCLUSIONS: As a rapidly ageing society, in order to address the increasing needs and inequalities in health care utilization, China is facing a massive challenge to reform the current health care system, improve equitable access to health insurance and financial affordability for the most disadvantaged, as well as to provide more health education and information to the general public. BioMed Central 2016-02-18 /pmc/articles/PMC4758158/ /pubmed/26892677 http://dx.doi.org/10.1186/s12913-016-1307-8 Text en © Gong et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Gong, Cathy Honge Kendig, Hal He, Xiaojun Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title | Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title_full | Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title_fullStr | Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title_full_unstemmed | Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title_short | Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013 |
title_sort | factors predicting health services use among older people in china: an analysis of the china health and retirement longitudinal study 2013 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758158/ https://www.ncbi.nlm.nih.gov/pubmed/26892677 http://dx.doi.org/10.1186/s12913-016-1307-8 |
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