College of Economics and Management, Shenyang Agricultural University, Dongling Road 120, Shenyang, Liaoning Province, China.
Int J Qual Health Care. 2021 Feb 20;33(1). doi: 10.1093/intqhc/mzaa142.
To determine whether or not chronic disease positively impacts medical costs among the rural elderly in China and to calculate medical expenditure induced by chronic disease between different groups of the rural elderly, as well as provide insight into the factors that affect medical losses induced by chronic disease among different household registration groups and different New Rural Pension Scheme statuses.
To estimate the share of medical expenses induced by chronic disease, this article uses a two-part model and a four-part model to analyze the causal effect of chronic disease on medical services and then uses a counter-factual method to estimate the share of medical expenses.
The rapid development of China has changed nearly every aspect of life for the rural elderly. Many are concerned about the increasing prevalence of physical health issues, particularly chronic diseases, among the rural elderly. Nevertheless, there are no articles using nationally representative panel datasets that report differences in the cost of chronic disease between sub-populations.
The panel dataset used for this study comes from the China Family Panel Studies (CFPS) data. In this study, we use the CFPS data for the years 2012, 2014 and 2016 to create a panel dataset that includes 2730 rural elderly for 3 years.
This article reports the representative estimate of medical expenditures attributable to chronic disease among rural elderly in China. On this basis, we estimate per capita medical spending among rural elderly under the condition of logarithmic normal distribution of different parameters between urban and rural or between groups that participate in the New Rural Pension Program and groups that do not.
This study indicates that physical health status has a significant impact on both the probability of undergoing medical care and the size of medical expenditures among the rural elderly, and the influence was significant for all patients, including outpatients and inpatients.
Chronic illness has significant effects on individual medical expenses, and they aggregately contribute to 63.96% of total personal expected medical expenditure. Specifically, the medical spending caused by chronic disease was part of a non-uniform distribution, with the rural, male, older, married and higher educated groups spending more money on medical costs induced by chronic disease.
Examining trends in the prevalence of chronic diseases and evaluating medical spending on chronic diseases can prevent and control potential medical costs among rural elderly, especially for vulnerable groups, which helps to predict future health-care needs.
确定慢性病是否会对中国农村老年人的医疗费用产生积极影响，并计算不同农村老年人群体慢性病引起的医疗支出，同时深入了解影响不同户籍群体和不同新型农村社会养老保险（新农保）参保状态下慢性病引起的医疗损失的因素。
为了估算慢性病引起的医疗费用份额，本文使用两部分模型和四部分模型来分析慢性病对医疗服务的因果效应，然后使用反事实方法来估计医疗费用份额。
中国的快速发展改变了农村老年人生活的方方面面。许多人担心农村老年人的身体健康问题，特别是慢性病的患病率不断上升。然而，目前还没有使用全国代表性面板数据集的文章报告不同亚人群中慢性病的成本差异。
本研究使用的面板数据集来自中国家庭追踪调查（CFPS）数据。在本研究中，我们使用 2012 年、2014 年和 2016 年的 CFPS 数据创建了一个包含 2730 名农村老年人的 3 年面板数据集。
本文报告了中国农村老年人慢性病引起的医疗支出的代表性估计值。在此基础上，我们根据城乡之间或参加新型农村社会养老保险（新农保）与未参加新农保群体之间不同参数的对数正态分布，估计不同参数下农村老年人的人均医疗支出。
本研究表明，身体健康状况对农村老年人接受医疗服务的概率和医疗支出的大小都有显著影响，而且这种影响对所有患者（包括门诊和住院患者）都是显著的。
慢性病对个人医疗费用有显著影响，它们共同占个人预期总医疗支出的 63.96%。具体来说，慢性病引起的医疗支出呈非均匀分布，农村、男性、年龄较大、已婚和受教育程度较高的群体在慢性病引起的医疗费用上花费更多。
研究慢性病的流行趋势和评估慢性病的医疗支出可以预防和控制农村老年人的潜在医疗费用，特别是对弱势群体，这有助于预测未来的医疗需求。
