TY - JOUR
T1 - Heterogeneous health profiles and healthcare utilization of the middle-aged and elderly with multiple health insurance schemes in China
AU - Ye, L.
AU - Shia, B. C.
AU - Fang, Y.
AU - Lee, T. S.
N1 - Publisher Copyright:
© 2019 The Royal Society for Public Health
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Objectives: China is facing an escalating demand of healthcare services from the middle-aged and elderly. Compared with the traditional view of health on symptoms and diseases, this study aimed to assess the heterogeneous health profiles of middle-aged and elderly Chinese by a person-centered approach. Furthermore, this study examined the effects of health profiles and associated factors on healthcare utilization within the context of China's multiple health insurance schemes. Study design: The study used the 2015 data of China Health and Retirement Longitudinal Study, a nationwide population-based sample of people aged 45 years and older. Methods: Latent class analysis (LCA) was adopted to identify the heterogeneous health profiles. Two-part models were adopted to assess the effects of associated factors on healthcare utilization. Results: Among 15,250 Chinese aged 45 years and older, six heterogeneous health profiles were identified and labeled as ‘Quite Healthy’, ‘Relatively Healthy’, ‘Comprehensive Comorbidities’, ‘Functional Impairment’, 'severe Disability’, and ‘Relatively Frail’. The Relatively Frail profile was the heaviest healthcare user. The Severe Disability profile took the least use of outpatient services but had relatively high utilization of inpatient services and outpatient expenditure. The Comprehensive Comorbidities profile tended to have the smallest effect on the frequency of visits for both inpatient and outpatient services, but its effect on outpatient expenditure was high. After controlling for health profiles, the significant effects of different health insurance programs on healthcare utilization were discussed. Conclusions: Introducing health profiles by the person-centered approach of LCA has provided a holistic understanding of complex healthcare demands for middle-aged and elderly Chinese. It is valuable for policy makers to improve healthcare resource allocation targeted for the middle-aged and elderly.
AB - Objectives: China is facing an escalating demand of healthcare services from the middle-aged and elderly. Compared with the traditional view of health on symptoms and diseases, this study aimed to assess the heterogeneous health profiles of middle-aged and elderly Chinese by a person-centered approach. Furthermore, this study examined the effects of health profiles and associated factors on healthcare utilization within the context of China's multiple health insurance schemes. Study design: The study used the 2015 data of China Health and Retirement Longitudinal Study, a nationwide population-based sample of people aged 45 years and older. Methods: Latent class analysis (LCA) was adopted to identify the heterogeneous health profiles. Two-part models were adopted to assess the effects of associated factors on healthcare utilization. Results: Among 15,250 Chinese aged 45 years and older, six heterogeneous health profiles were identified and labeled as ‘Quite Healthy’, ‘Relatively Healthy’, ‘Comprehensive Comorbidities’, ‘Functional Impairment’, 'severe Disability’, and ‘Relatively Frail’. The Relatively Frail profile was the heaviest healthcare user. The Severe Disability profile took the least use of outpatient services but had relatively high utilization of inpatient services and outpatient expenditure. The Comprehensive Comorbidities profile tended to have the smallest effect on the frequency of visits for both inpatient and outpatient services, but its effect on outpatient expenditure was high. After controlling for health profiles, the significant effects of different health insurance programs on healthcare utilization were discussed. Conclusions: Introducing health profiles by the person-centered approach of LCA has provided a holistic understanding of complex healthcare demands for middle-aged and elderly Chinese. It is valuable for policy makers to improve healthcare resource allocation targeted for the middle-aged and elderly.
KW - Aging
KW - China
KW - Health insurance
KW - Health profile
KW - Healthcare utilization
KW - Latent class analysis
UR - http://www.scopus.com/inward/record.url?scp=85063760570&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063760570&partnerID=8YFLogxK
U2 - 10.1016/j.puhe.2019.01.011
DO - 10.1016/j.puhe.2019.01.011
M3 - Article
C2 - 30954778
AN - SCOPUS:85063760570
SN - 0033-3506
VL - 170
SP - 61
EP - 69
JO - Public Health
JF - Public Health
ER -
