Introduction
Methods and data
Measuring CHE incidence and intensity
CHE concentration index
CHE determinants and the decomposition of CI
Data source
Variables
|
Description
|
Elderly household with chronic disease patients
|
Elderly household that did not report chronic disease
| |
---|---|---|---|---|
Mean(S.D.)
|
Mean(S.D.)
| |||
Household expenditure and OOP health expenditure | ||||
OOP payment for health care | Household OOP medical expense over the last year (yuan RMB) | 3227.07 (105.88) | 1652.54 (207.06) | |
OOP payment of chronic disease patients | OOP medical expense of chronic disease patients over the last year (yuan RMB) | 2513.83 (84.76) | - | |
Non-food household expenditure | Household Non-food expenditure over the last year (yuan RMB) | 14921.84 (402.07) | 12785.67 (596.89) | |
Household socioeconomic factors | ||||
Marital status | =1 if married; =2 if divorced, widowed or never married. | 1.1908 (0.0045) | 1.3206 (0.0109) | |
Household size | =1 if living with children; =0 otherwise. | 0.6570 (0.0054) | 0.6990 (0.0107) | |
Receipt of economic assistance | =1 if receiving economic supports; =0 otherwise. | 0.4104 (0.0056) | 0.3206 (0.0109) | |
Provision of economic assistance | =1 if providing economic supports; =0 otherwise. | 0.3605 (0.0055) | 0.3495 (0.0111) | |
Providing care | =1 if spending time taking care of grandchildren or parents; =0 otherwise. | 0.3940 (0.0056) | 0.3128 (0.0110) | |
Household members > 65 years | =1 if having one or more members over 65 years of age; =0 otherwise. | 0.3515 (0.0055) | 0.2789 (0.0107) | |
Household members with ≥ 2 chronic diseases | =1 if any patient has two or more chronic diseases; =0 otherwise. | 0.6398 (0.0055) | - | |
Per capita income | household income per capita over the last year(yuan RMB) | 9653.96 (175.31) | 10777.86 (405.67) | |
Healthcare insurance | =1if all patients have healthcare insurance; =0 otherwise. | 0.9361 (0.2444) | 0.9153 (0.2784) | |
Health-care seeking behaviors | ||||
Outpatient service | Health care post or Village clinic | =1 if the elderly go to health care post or village clinic for treatment; =0 otherwise. | 0.0955 (0.0034) | 0.0447 (0.0048) |
First-level hospital | =1 if the elderly go to first-level hospital for treatment; =0 otherwise. | 0.0496 (0.0025) | 0.0224 (0.0035) | |
Second-level hospital and above | =1 if the elderly go to second-level hospital or above for treatment; =0 otherwise. | 0.0754 (0.0030) | 0.0289 (0.0039) | |
Inpatient service | First-level hospital | =1 if the elderly go to first-level hospital for hospitalization; =0 otherwise. | 0.0222 (0.0017) | 0.0076 (0.0020) |
Second-level hospital and above | =1 if the elderly go to second-level hospital or above for hospitalization; =0 otherwise. | 0.0611 (0.0027) | 0.0311 (0.0041) |
Results
CHE incidence and intensity in elderly households
Catastrophic threshold (share of non-food household expenditure)
| ||||||
---|---|---|---|---|---|---|
20%
|
30%
|
40%
|
50%
|
60%
| ||
Entire elderly households | Headcount | 44.53% | 33.62% | 25.64% | 19.59% | 13.90% |
Overshoot | 13.03% | 9.14% | 6.21% | 3.95% | 2.28% | |
Mean positive overshoot | 29.22% | 27.20% | 24.19% | 20.14% | 16.27% | |
Rural elderly households with chronic disease patients | Headcount | 51.64% | 39.68% | 30.57% | 23.46% | 16.93% |
Overshoot | 15.66% | 11.10% | 7.60% | 4.88% | 2.85% | |
Mean positive overshoot | 30.33% | 27.98% | 24.85% | 20.82% | 16.85% | |
Urban elderly households with chronic disease patients | Headcount | 38.73% | 28.44% | 22.03% | 17.23% | 10.50% |
Overshoot | 10.92% | 7.57% | 5.08% | 3.10% | 1.64% | |
Mean positive overshoot | 28.18% | 26.63% | 23.06% | 17.97% | 15.66% | |
Rural elderly households that did not report chronic disease | Headcount | 29.10% | 20.84% | 13.54% | 9.58% | 7.19% |
Overshoot | 7.52% | 5.05% | 3.33% | 3.10% | 1.34% | |
Mean positive overshoot | 25.85% | 24.24% | 24.57% | 22.69% | 18.61% | |
Urban elderly households that did not report chronic disease | Headcount | 14.86% | 9.87% | 8.23% | 5.12% | 3.12% |
Overshoot | 3.82% | 2.60% | 1.72% | 1.07% | 0.67% | |
Mean positive overshoot | 25.70% | 26.28% | 20.84% | 20.88% | 21.51% | |
Diff-1 | Headcount | 0.1200**
| 0.1042**
| 0.0808**
| 0.0579**
| 0.0520**
|
(S.D.) | 0.0136 | 0.0131 | 0.0123 | 0.0113 | 0.0100 | |
Overshoot | 0.0446**
| 0.0332**
| 0.0237**
| 0.0166**
| 0.0109**
| |
(S.D.) | 0.0058 | 0.0048 | 0.0038 | 0.0029 | 0.002 | |
Diff-2 | Headcount | −0.2214**
| −0.1790**
| −0.1521**
| −0.1294**
| −0.0934**
|
(S.D.) | 0.0131 | 0.0125 | 0.0115 | 0.0105 | 0.0092 | |
Overshoot | −0.0763**
| −0.0561**
| −0.0396**
| −0.0254**
| −0.0141**
| |
(S.D.) | 0.0055 | 0.0045 | 0.0036 | 0.0027 | 0.0019 |
Determinants of CHE in elderly households with chronic disease patients
Incidence of CHE
|
Intensity of CHE
| ||||||||
---|---|---|---|---|---|---|---|---|---|
Rural areas
|
Urban areas
|
Rural areas
|
Urban areas
| ||||||
Coefficient
|
S.D.
|
Coefficient
|
S.D.
|
Coefficient
|
S.D.
|
Coefficient
|
S.D.
| ||
Marital status | 0.1887 | 0.1638 | 0.2316 | 0.1747 | −0.0004 | 0.0060 | 0.0188 | 0.0106 | |
Household size | −0.3182**
| 0.0487 | −0.4802**
| 0.0948 | −0.0649**
| 0.0055 | −0.0300**
| 0.0080 | |
Receipt of economic assistance | 0.0809 | 0.0462 | −0.0718 | 0.1480 | 0.0075 | 0.0043 | −0.0001 | 0.0116 | |
Provision of economic assistance | 0.1794**
| 0.0505 | 0.1081 | 0.1355 | 0.0190**
| 0.0047 | 0.0089 | 0.0091 | |
Providing care | −0.0273 | 0.0485 | −0.0024 | 0.0959 | −0.0051 | 0.0043 | −0.0054 | 0.0080 | |
Household members > 65 years | 0.1345**
| 0.0497 | 0.2252 | 0.1540 | 0.0126*
| 0.0052 | 0.0112 | 0.0096 | |
Household members with ≥ 2 chronic diseases | 0.3871**
| 0.0450 | 0.6050**
| 0.1255 | 0.0287**
| 0.0041 | 0.0339**
| 0.0074 | |
Per capita income | −0.0153**
| 0.0038 | −0.0366**
| 0.0131 | −0.0057**
| 0.0014 | −0.0070 | 0.0040 | |
Healthcare insurance | 0.2651 | 0.1557 | −0.3086 | 0.2189 | 0.0069 | 0.0101 | −0.0123 | 0.0110 | |
Outpatient service | Health care post or village clinic | 0.1927**
| 0.0667 | −0.5182 | 0.3017 | 0.0194**
| 0.0070 | −0.0295*
| 0.0127 |
First-level hospital | 0.3235**
| 0.0878 | 0.2535 | 0.2891 | 0.0234*
| 0.0098 | 0.0219 | 0.0377 | |
Second-level hospital and above | 0.3537**
| 0.0905 | 0.1730 | 0.1577 | 0.0410**
| 0.0106 | 0.0174 | 0.0131 | |
Inpatient service | First-level hospital | 0.4539**
| 0.1083 | −0.1315 | 0.6303 | 0.0676**
| 0.0163 | 0.0205 | 0.0419 |
Second-level hospital and above | 0.7031**
| 0.0937 | 0.9663**
| 0.2808 | 0.0931**
| 0.0118 | 0.0725**
| 0.0207 | |
Constant | −0.1555 | 0.1434 | −0.1850 | 0.4640 | 0.1337**
| 0.0158 | 0.0871*
| 0.0435 |
CHE inequality in elderly households
Catastrophic threshold (share of non-food household expenditure)
| ||||||
---|---|---|---|---|---|---|
20%
|
30%
|
40%
|
50%
|
60%
| ||
Rural elderly households with chronic disease patients | Incidence | −0.0841 | −0.1111 | −0.1488 | −0.1704 | −0.1857 |
Intensity | −0.1502 | −0.1729 | −0.1923 | −0.2090 | −0.2335 | |
Urban elderly households with chronic disease patients | Incidence | −0.1246 | −0.1438 | −0.1433 | −0.1284 | −0.1522 |
Intensity | −0.1433 | −0.1465 | −0.1482 | −0.1559 | −0.1867 | |
Rural elderly households that did not report chronic disease | Incidence | −0.0981 | −0.1448 | −0.1955 | −0.2049 | −0.1905 |
Intensity | −0.1718 | −0.1951 | −0.2098 | −0.2128 | −0.2274 | |
Urban elderly households that did not report chronic disease | Incidence | −0.3362 | −0.4117 | −0.3956 | −0.3833 | −0.4021 |
Intensity | −0.4205 | −0.4418 | −0.4595 | −0.5069 | −0.5765 |
Decomposition of CHE inequality in elderly households with chronic disease patients
Rural areas
|
Urban areas
| ||||||||
---|---|---|---|---|---|---|---|---|---|
Elasticity
|
Concentration index (CI)
|
Contribution to CI
|
Contribution to CI %
|
Elasticity
|
Concentration index (CI)
|
Contribution to CI
|
Contribution to CI %
| ||
Marital status | 0.6974 | 0.0397 | 0.0277 | −18.61% | 0.865 | 0.0591 | 0.0511 | −35.66% | |
Household size | −0.7269 | 0.1474 | −0.1071 | 72.00% | −1.2236 | 0.0859 | −0.1051 | 73.35% | |
Receipt of economic assistance | 0.1117 | −0.0884 | −0.0098 | 6.64% | −0.0936 | −0.1343 | 0.0126 | −8.79% | |
Provision of economic assistance | −0.2047 | 0.0906 | −0.0185 | 12.43% | −0.1981 | 0.0741 | −0.0147 | 10.26% | |
Providing care | −0.0349 | 0.0784 | −0.0027 | 1.81% | −0.0047 | 0.073 | −0.0003 | 0.21% | |
Household members > 65 years | 0.1562 | −0.132 | −0.0206 | 13.84% | 0.3505 | −0.0729 | −0.0256 | 17.86% | |
Household members with ≥ 2 chronic diseases | 0.7874 | −0.0161 | −0.0127 | 8.53% | 1.812 | −0.0433 | −0.0784 | 54.71% | |
Per capita income | −0.3505 | 0.0901 | −0.0316 | 21.22% | −1.4713 | 0.0434 | −0.0638 | 44.52% | |
Health insurance | 0.8086 | 0.0048 | 0.0039 | −2.61% | −1.2086 | −0.0014 | 0.0017 | −1.19% | |
Outpatient service | Health care post or Village clinic | 0.0725 | −0.0402 | −0.0029 | 1.95% | −0.0566 | −0.3169 | 0.0179 | −12.49% |
First-level hospital | 0.056 | 0.0364 | 0.002 | −1.34% | 0.0566 | −0.0341 | −0.0019 | 1.33% | |
Second-level hospital and above | 0.0722 | 0.0093 | 0.0007 | −0.47% | 0.1111 | 0.1978 | 0.022 | −15.35% | |
Inpatient service | First-level hospital | 0.0388 | −0.143 | −0.0055 | 3.70% | −0.0022 | −0.1359 | −0.0016 | 1.12% |
Second-level hospital and above | 0.1232 | −0.0368 | −0.0045 | 3.02% | 0.4483 | 0.099 | 0.0444 | −30.98% | |
Total | −0.1619 | 108.84% | −0.1417 | 98.88% |
Rural areas
|
Urban areas
| ||||||||
---|---|---|---|---|---|---|---|---|---|
Elasticity
|
Concentration index (CI)
|
Contribution to CI
|
Contribution to CI %
|
Elasticity
|
Concentration index (CI)
|
Contribution to CI
|
Contribution to CI %
| ||
Marital status | −0.0043 | 0.0397 | −0.0002 | 0.09% | 0.3049 | 0.0591 | 0.018 | −12.15% | |
Household size | −0.5652 | 0.1474 | −0.1211 | 62.99% | −1.1583 | 0.0859 | −0.0995 | 67.14% | |
Receipt of economic assistance | 0.0443 | −0.0884 | −0.0039 | 2.04% | −0.0008 | −0.1343 | 0.0001 | −0.07% | |
Provision of economic assistance | −0.0874 | 0.0906 | −0.0079 | 4.12% | −0.0705 | 0.0741 | −0.0052 | 3.51% | |
Providing care | −0.0264 | 0.0784 | −0.0021 | 1.08% | −0.0454 | 0.073 | −0.0033 | 2.23% | |
Household members > 65 years | 0.0588 | −0.132 | −0.0078 | 4.04% | 0.0757 | −0.0729 | −0.0055 | 3.71% | |
Household members with ≥ 2 chronic diseases | 0.2352 | −0.0161 | −0.0038 | 1.97% | 0.4407 | −0.0433 | −0.0191 | 12.89% | |
Per capita income | −0.5996 | 0.0901 | −0.054 | 28.10% | −1.3067 | 0.0434 | −0.0567 | 38.26% | |
Health insurance | 0.0844 | 0.0048 | 0.0004 | −0.21% | −0.2097 | −0.0014 | 0.0003 | −0.20% | |
Outpatient service | Health care post or Village clinic | 0.0294 | −0.0402 | −0.0012 | 0.61% | −0.014 | −0.3169 | 0.0044 | −2.97% |
First-level hospital | 0.0163 | 0.0364 | 0.0006 | −0.31% | 0.0212 | −0.0341 | −0.0007 | 0.47% | |
Second-level hospital and above | 0.0337 | 0.0093 | 0.0003 | −0.16% | 0.0484 | 0.1978 | 0.0096 | −6.48% | |
Inpatient service | First-level hospital | 0.0232 | −0.143 | −0.0033 | 1.73% | 0.0015 | −0.1359 | −0.0002 | 0.13% |
Second-level hospital and above | 0.0657 | −0.0368 | −0.0024 | 1.26% | 0.1458 | 0.099 | 0.0144 | −9.72% | |
Total | −0.2064 | 107.35% | −0.1434 | 96.76% |