The Health Status Transition and Medical Expenditure Evaluation of Elderly Population in China

Abstract

(1) Background: Because of the rapid expansion of the aging population in China, their health status transition and future medical expenditure have received increasing attention. This paper analyzes the health transition of the elderly and how their health transition impacts medical expenditures. At the same time, feasible policy suggestions are provided to respond to the rising medical expenditure and the demand for social care. (2) Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 and analyzed using the Markov model and the Two-Part model (TPM) to forecast the size of the elderly population and their medical expenditures for the period 2020–2060. (3) Results: The study indicates that: (1) for the elderly with a mild disability, the probability of their health improvement is high; in contrast, for the elderly with a moderate or severe disability, their health deterioration is almost certain; (2) the frequency of the diagnosis and treatments of the elderly is closely related to their health status and medical expenditure; alternatively, as the health status deteriorates, the intensity of the elderly individuals’ acceptance of their diagnosis and treatment increases, and so does the medical expense; (3) the population of the elderly with mild and moderate disability demonstrates an inverted “U”-shape, which reaches a peak around 2048, whereas the elderly with severe disability show linear growth, being the target group for health care; (4) with the population increase of the elderly who have severe disability, the medical expenditure increases significantly and poses a huge threat to medical service supply. Conclusions: It is necessary to provide classified and targeted health care according to the health status of the elderly. In addition, improving the level of medical insurance, establishing a mechanism for sharing medical expenditure, and adjusting the basic demographic structure are all important policy choices.

Medical expenditure and its inequity for people with disabilities: Evidence from the CHARLS 2018 data

“…Family caregivers can provide self-care training for the disabled to ensure their basic living and self-care ability and promote the rehabilitation of the mental, physical, and social functions of people with disabilities ( 59 ). Additionally, the different effects of socioeconomic factors in the different disability groups also indicated that precise, classified, and targeted efforts in health care should be made by considering these different demand-side health needs according to disability types ( 60 , 61 ).…”

Exploring Chinese Elderly’s Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China

“…Older people are a vulnerable group confronting a higher risk of chronic diseases and declination of health conditions. The health risk of the elderly will cause rising demand for medical services and medical expenditure from 2020–2060 [ 41 ]. With the demographic transition, the aging population poses greater challenges to China’s public health than ever.…”

Will the Policy Instruments Mix Promote the Facility Input of Care Institutions for Older People in China?

“…The study contributes to the literature on care for older people from the view of policy support. Theoretical research on the policy instrument mix in terms of input of care institutions for older people has been paid attention recently ( 2 , 29 ). However, studies focusing on the combined effects of different characteristics of a policy instrument mix are scarce ( 9 , 30 ).…”

“…As of November 2020, China recorded 264.02 million people aged over 60, accounting for 18.7% of the total population, and 190.64 million people aged over 65, representing 13.5% of the overall population. Care for older people has become a significant issue affecting social development in China ( 1 , 2 ). With a decline in the birth rate and family care functions, community care and home care have failed to provide older people high-quality care services.…”