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Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China

BACKGROUND: Studies have shown chronic disease-based healthcare utilization inequity is common. Hence, exploring this issue can help in establishing targeted measures and protecting the rights and interests of vulnerable groups. Against this background, the purpose of this study is to explore the la...

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Autores principales: Zhao, Jie, Yan, Chaoyang, Han, Dan, Wu, Yunyi, Liao, Hui, Ma, Ying, Zhang, Mei, Li, Sangsang, Wang, Jing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650823/
https://www.ncbi.nlm.nih.gov/pubmed/36357825
http://dx.doi.org/10.1186/s12877-022-03538-x
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author Zhao, Jie
Yan, Chaoyang
Han, Dan
Wu, Yunyi
Liao, Hui
Ma, Ying
Zhang, Mei
Li, Sangsang
Wang, Jing
author_facet Zhao, Jie
Yan, Chaoyang
Han, Dan
Wu, Yunyi
Liao, Hui
Ma, Ying
Zhang, Mei
Li, Sangsang
Wang, Jing
author_sort Zhao, Jie
collection PubMed
description BACKGROUND: Studies have shown chronic disease-based healthcare utilization inequity is common. Hence, exploring this issue can help in establishing targeted measures and protecting the rights and interests of vulnerable groups. Against this background, the purpose of this study is to explore the latent classification of elderly patients with chronic disease and compare healthcare utilization inequity among latent classes. METHODS: This study used the data of 7243 elderly patient with chronic diseases collected from the China Health and Retirement Longitudinal Study in 2018. Latent class analysis was used to classify the patients with chronic diseases, and analysis of variance and [Formula: see text] tests were utilized to test the differences in characteristics among latent classes. Healthcare utilization inequity was measured based on the concentration index (CI), and the CI was decomposed to compare the horizontal index of healthcare utilization among the latent classes. RESULTS: The patients with chronic diseases were divided into five latent classes, namely, the musculoskeletal system, hypertension, respiratory system, digestive system and cardiovascular system groups. Statistically significant differences in social demographic characteristics were observed among the five latent classes (P < 0.05). A pro-rich healthcare utilization inequity for all respondents was observed (outpatient CI = 0.080, inpatient CI = 0.135), and a similar phenomenon in latent classes was found except for the musculoskeletal system group in outpatient visits (CI = -0.037). The digestive system group had the worst equity (outpatient CI = 0.197, inpatient CI = 0.157) and the respiratory system group had the best (outpatient CI = 0.001, inpatient CI = 0.086). After balancing the influence of health need factors, healthcare utilization inequity was almost alleviated. Furthermore, for all respondents, the contribution of health need factors (65.227% for outpatient and 81.593% for inpatient) was larger than that of socioeconomic factors (-21.774% for outpatient and 23.707 for inpatient), and self-rated health status was the greatest contributor (57.167% for outpatient and 79.399% for inpatient). The characteristics were shown in latent classes. CONCLUSIONS: Healthcare utilization inequity still exists in elderly patients with chronic diseases, and the specific performances of inequity vary among latent classes. Moreover, self-rated health status plays an important role in healthcare utilization inequity. Providing financial support to low-income patients with certain chronic diseases, focusing on their physical and mental feelings and guiding them to evaluate their health status correctly could be essential for alleviating healthcare utilization inequity among elderly patients with chronic diseases.
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spelling pubmed-96508232022-11-15 Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China Zhao, Jie Yan, Chaoyang Han, Dan Wu, Yunyi Liao, Hui Ma, Ying Zhang, Mei Li, Sangsang Wang, Jing BMC Geriatr Research BACKGROUND: Studies have shown chronic disease-based healthcare utilization inequity is common. Hence, exploring this issue can help in establishing targeted measures and protecting the rights and interests of vulnerable groups. Against this background, the purpose of this study is to explore the latent classification of elderly patients with chronic disease and compare healthcare utilization inequity among latent classes. METHODS: This study used the data of 7243 elderly patient with chronic diseases collected from the China Health and Retirement Longitudinal Study in 2018. Latent class analysis was used to classify the patients with chronic diseases, and analysis of variance and [Formula: see text] tests were utilized to test the differences in characteristics among latent classes. Healthcare utilization inequity was measured based on the concentration index (CI), and the CI was decomposed to compare the horizontal index of healthcare utilization among the latent classes. RESULTS: The patients with chronic diseases were divided into five latent classes, namely, the musculoskeletal system, hypertension, respiratory system, digestive system and cardiovascular system groups. Statistically significant differences in social demographic characteristics were observed among the five latent classes (P < 0.05). A pro-rich healthcare utilization inequity for all respondents was observed (outpatient CI = 0.080, inpatient CI = 0.135), and a similar phenomenon in latent classes was found except for the musculoskeletal system group in outpatient visits (CI = -0.037). The digestive system group had the worst equity (outpatient CI = 0.197, inpatient CI = 0.157) and the respiratory system group had the best (outpatient CI = 0.001, inpatient CI = 0.086). After balancing the influence of health need factors, healthcare utilization inequity was almost alleviated. Furthermore, for all respondents, the contribution of health need factors (65.227% for outpatient and 81.593% for inpatient) was larger than that of socioeconomic factors (-21.774% for outpatient and 23.707 for inpatient), and self-rated health status was the greatest contributor (57.167% for outpatient and 79.399% for inpatient). The characteristics were shown in latent classes. CONCLUSIONS: Healthcare utilization inequity still exists in elderly patients with chronic diseases, and the specific performances of inequity vary among latent classes. Moreover, self-rated health status plays an important role in healthcare utilization inequity. Providing financial support to low-income patients with certain chronic diseases, focusing on their physical and mental feelings and guiding them to evaluate their health status correctly could be essential for alleviating healthcare utilization inequity among elderly patients with chronic diseases. BioMed Central 2022-11-11 /pmc/articles/PMC9650823/ /pubmed/36357825 http://dx.doi.org/10.1186/s12877-022-03538-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Zhao, Jie
Yan, Chaoyang
Han, Dan
Wu, Yunyi
Liao, Hui
Ma, Ying
Zhang, Mei
Li, Sangsang
Wang, Jing
Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title_full Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title_fullStr Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title_full_unstemmed Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title_short Inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in China
title_sort inequity in the healthcare utilization among latent classes of elderly people with chronic diseases and decomposition analysis in china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650823/
https://www.ncbi.nlm.nih.gov/pubmed/36357825
http://dx.doi.org/10.1186/s12877-022-03538-x
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