Does self-medication reduce medical expenditure among the middle-aged and elderly population? A four-wave longitudinal study in China

Abstract

IntroductionSelf-medication has a high prevalence in the middle-aged and elderly population in China. Despite the published evidence demonstrating the economic benefits of self-medication, limited research has addressed the relationship between self-medication and individual medical expenditures, especially within the Chinese population. This study examined the effect of self-medication on individual medical expenditures in China and analyzed the heterogeneity between outpatient and inpatient cases.MethodsWe conducted a panel data analysis using data from four waves of the China Health and Retirement Longitudinal Study (CHARLS). Two-part mixed-effect models were implemented to estimate the effect of self-medication on total outpatient and inpatient expenses and out-of-pocket (OOP) costs, where mixed-effects logit regression was used as the first part, and generalized linear mixed models with log link and gamma distribution was used as the second part.ResultsWe identified 72,041 responses representing 24,641 individuals, of which 13,185 responses incurred outpatient expenses and 9,003 responses incurred inpatient costs. Controlling for all covariates, we found that self-medication behaviors were significantly associated with a higher probability of outpatient service utilization (OR = 1.250, 95% CI = 0.179 to 0.269; P < 0.001), but displayed no significant association with outpatient expenses. Respondents who had taken self-medication were less likely to use inpatient services (OR = 0.865, 95% CI = −0.201 to −0.089; P < 0.001), and their inpatient expenses were significantly reduced by 9.4% (P < 0.001). Inpatient OOP costs were significantly reduced by 10.7% (P < 0.001), and outpatient OOP costs were significantly increased by 11.3% (P < 0.001) among respondents who had self-medicated.ConclusionsThis study allowed us to identify the economic value of self-medication among the middle-aged and elderly population in China. Future work should guide the middle-aged and elderly to take responsible self-medication to reduce their economic burden.

Impact of Pension Income on Healthcare Utilization of Older Adults in Rural China

“…From a public health and national burden of disease perspective, suppression of healthcare needs often leads to disease exacerbation, causes augmented disease risk and constraints disease treatment and prevention, which increases the social burden of long-run healthcare [63-64]. In addition, in the individual perspective, studies suggested that The elderly who adopt selfmedication are less likely to use inpatient services, and their hospitalization costs are signi cantly lower [21].…”

“…Compared to urban respondents, rural residents were more likely to consider drug price as a decision factor in purchasing over-thecounter drugs [17]. Proper self-medication can reduce the long-term healthcare burden at the individual and societal level [21][22]. In addition to conventional healthcare resources such as inpatient and outpatient care, self-medication, especially over-the-counter drugs, deserves special attention for rural residents.…”

Impact of pension income on healthcare utilization of older adults in rural China

“…From a public health and national burden of disease perspective, suppression of healthcare needs often leads to disease exacerbation, causes augmented disease risk and constraints disease treatment and prevention, which increases the social burden of long-run healthcare [ 64 , 65 ]. In addition, in the individual perspective, studies suggested that the elderly who adopt self-medication are less likely to use inpatient services, and their hospitalization costs are significantly lower [ 21 ]. The economic value of self-medication among the Chinese elderly population is also significant at the individual level.…”

“…Compared to urban respondents, rural residents were more likely to consider drug price as a decision factor in purchasing over-the-counter drugs [ 17 ]. Proper self-medication can reduce the long-term healthcare burden at the individual and societal level [ 21 , 22 ]. In addition to conventional healthcare resources such as inpatient and outpatient care, self-medication, especially over-the-counter drugs, deserves special attention for rural residents.…”

Factors associated with the incidence and the expenditure of self-medication among middle-aged and older adults in China: A cross-sectional study

“…The results indicated an increasingly trend of self-medication among middle-aged and older adults in China and the growing pharmaceutical expenditure that come with it. According to prior study, the popularity of self-medication in this group can be attributed to its cost and time savings ( 31 ).…”