Department of Economics, Fordham University, Bronx, NY 10458, USA.
College of Business and Economics, Fayetteville State University, Fayetteville, NC 28301, USA.
Int J Environ Res Public Health. 2023 Jul 27;20(15):6465. doi: 10.3390/ijerph20156465.
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.
本研究旨在估算中国慢性健康状况和残疾相关的生活额外成本。利用涉及 13530 名 50 岁及以上受访者的 2018 年中国健康与退休纵向研究，我们同时应用普通最小二乘法线性回归模型和逻辑模型来分析医疗自付支出（OOPEs）与慢性健康状况以及日常生活活动（ADL）和工具性日常生活活动（IADL）限制所测残疾之间的相关性。本文填补了 OOPEs 及其与残疾和慢性健康状况的关联方面文献的空白。我们发现，ADL 限制、IADL 限制和慢性健康状况均与更高的 OOPEs 密切相关。有残疾和慢性健康状况的老年人发生 OOPEs 的几率是没有残疾和慢性健康状况的老年人的两到三倍。有残疾和慢性健康状况的人 OOPEs 最高。研究结果表明，需要更多的政策和研究关注，以改善对患有慢性健康状况和残疾的人的财务保护，包括通过获得全面的医疗保险覆盖。
