Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?

Wang, Jianyun; Pei, Yaolin; Zhong, Renyao; Wu, Bei

doi:10.3390/ijerph17124256

Cited by 7 publications

(6 citation statements)

References 46 publications

(56 reference statements)

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“…However, despite having close family or friends, older adults still seem to prefer to overcome difficulties on their own rather than seek help, in order to avoid being a burden to others [24][25][26][27]. Older adults who are at an advanced age, live alone, with financial difficulties and no medical insurance, and have lower participation in community activities are likely to have a lower utilization of social support due to lack of information and a limited range of activities [18,19,28,29].…”

Section: Introductionmentioning

confidence: 99%

Why do older adults living alone in cities cease seeking assistance? A qualitative study in China

Gong

Qin

et al. 2022

BMC Geriatr

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Background Against the background of an aging population, older adults living alone in cities are increasingly dependent. However, their use of home and community-based services in China is unsatisfactory. This study attempted to figure out why older adults living alone in cities do not actively seek assistance in China. Methods In-depth interviews were conducted. A total of 29 older adults were recruited. Content analysis was used to analyze the interview data. Results Three themes were identified. (1) Desire for independence, despite hardship: The lives of older adults involve many inconveniences, but they preferred to solve problems by themselves, instead of asking for help; (2) Desire to not overburden jiaren (meaning family in Chinese): older adults did not want to disturb families or burden children with caring responsibilities. Moreover, previous experience of failing to obtain care made them reluctant to seek help from jiaren; (3) Desire to not bother wairen (meaning people other than family in Chinese): The lack of trust caused by being unfamiliar with wairen, and the fear of being a burden to others if they were not able to reciprocate, made older adults reluctant to seek help from wairen. Conclusions Changes in social, economic, and demographic structures have led to gradual failure of family care. Older adults accustomed to an “acquaintance society” have not yet adapted to seeking help from the community. When addressing the problem of care for older adults living alone in cities, it is important to focus on the profound impact of social change.

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Section: Introductionmentioning

confidence: 99%

Why do older adults living alone in cities cease seeking assistance? A qualitative study in China

Gong

Qin

et al. 2022

BMC Geriatr

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“…In China, residents aged 35+ years would have their blood pressure assessed by doctors at their visits to hospitals or primary care centers since 2012 (10). Meanwhile, it has been documented consistently that the favorable health insurance scheme may increase the likelihood for people to seek health service at hospitals or primary care centers in China (11)(12)(13)(14)(15)(16)(17)(18)(19)36). Thus, beneficiaries with the favorable health insurance scheme (e.g., UEBMI in our study) were more likely to visit hospitals or primary care centers for seeking health service, and consequently had their blood pressure measured by doctors, and then had hypertension diagnosed by a doctor if they had the condition.…”

Section: Discussionmentioning

confidence: 99%

“…In such a case, individuals with HTN can be diagnosed as early as possible. Interestingly, health insurance has been investigated to be positively associated with visit to hospitals/ primary care centers among residents, particularly urban inhabitants in China (11)(12)(13)(14)(15)(16)(17)(18)(19). Moreover, health insurance was also examined in a positive relation to diagnosis of HTN for age-specific adults in USA and China (20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

A potential pathway for identifying hypertension among urban residents aged 60+ years in China: the role of health insurance

Dou,

Guo,

Liu

et al. 2024

Front. Public Health

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BackgroundIdentification is the first step for treatment of hypertension. However, the awareness rate of hypertension was not high globally. This study aimed to examine the potential role of health insurance for early-identifying hypertension among urban older residents in China.MethodsIn this cross-sectional study, urban residents aged 60+ years were chosen from Nanjing municipality of China in 2018. The outcome measure was hypertension status (“no hypertension,” “diagnosed hypertension” or “un-diagnosed hypertension”). Independent variable was health insurance (“Urban Employee Basic Medical Insurance scheme, UEBMI” or “Urban Resident Basic Medical Insurance scheme, URBMI”). Logistic regression models were introduced to estimate odds ratio (OR) and 95% confidence interval (CI) to examine the association between health insurance and hypertension.ResultsTotally, 19,742 participants completed the study. Among overall, URBMI and UEBMI participants, 47.2% (95%CI = 46.5, 47.9%), 38.4% (95%CI = 37.3, 39.6%) and 52.1% (95%CI = 51.2, 53.0%), separately, were diagnosed with hypertension, while the prevalence of un-diagnosed hypertension was 12.7% (95%CI = 12.2, 13.2%), 18.5% (95%CI = 17.6, 19.4%) and 9.6% (95%CI = 9.1, 10.1%), respectively. For overall participants, those with UEBMI were more likely to have hypertension identified (OR = 1.20; 95%CI = 1.11, 1.29) and at lower odds to experience un-diagnosed hypertension (OR = 0.68; 95%CI = 0.61, 0.76) compared to their counterparts with URBMI after control for potential confounders. Moreover, such associations of health insurance with diagnosed and un-diagnosed hypertension were also observed among participants stratified by age and gender.ConclusionFavorable health insurance may be a pathway for identifying hypertension among urban older residents in China. This study has important public health implications that hypertension may be identified early through favorable health insurance policies for older residents in China.

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“…Wang et al investigated the relationships among health insurance, city of residence, and outpatient visits among the elderly living alone in China and found that those who had basic medical insurance for urban employees, basic medical insurance for urban residents, and public medical insurance could easily make outpatient visits compared to older adults living alone without health insurance [34]. After controlling for the number of chronic diseases, only those with public health insurance were more likely to visit a clinic than those without insurance.…”

Section: A Medical Insurance Systemmentioning

confidence: 99%

Exploring the Intention of Middle-Aged and Elderly Consumers to Participate in Inclusive Medical Insurance

Liu

Jing

et al. 2022

IEEE Access

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With the sudden and heavy consequences of diseases, medical insurance has become a vital part of the medical system. Inclusive medical insurance (IMI) aims to help people manage personal health risks from an economic perspective under the cooperation of government and private enterprises. With the worsening aging phenomenon in China, middle-aged and elderly consumers inevitably need to choose insurance services. However, the diversification of service forms and contents implies potential loopholes that may affect their intention to participate in insurance. In this study, we establish a trust mechanism model combining finance, technology, and institutions; collect and organize data using questionnaires; and explore the link between trust and intention to participate in IMI. Our results show that new service concepts under digital channels can increase financial trust, perceived ease of use affects technical trust, and reputation and security mechanisms positively affect institutional trust. Furthermore, trust transfer occurs among the three types of trust. At the same time, financial trust and institutional trust positively affect middle-aged and elderly consumers' intention to participate in insurance. The findings of our study have theoretical value and practical implications for IMI research.

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Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?

Cited by 7 publications

References 46 publications

Why do older adults living alone in cities cease seeking assistance? A qualitative study in China

Why do older adults living alone in cities cease seeking assistance? A qualitative study in China

A potential pathway for identifying hypertension among urban residents aged 60+ years in China: the role of health insurance

Exploring the Intention of Middle-Aged and Elderly Consumers to Participate in Inclusive Medical Insurance

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