FACTORS INFLUENCING HEALTH CARE UTILIZATION AMONG MIDDLE AGED AND ELDERLY PEOPLE IN CHINA

Abstract

Background: China's one-child policy, significant advancement in health care, increase in life expectancy and decrease in birth rate all contribute to rapidly aging society. Proportion of elderly will continue to grow, which will put more burden on an already troubled health care system. This study tries to assess factors influencing health care utilization among middle-aged and elderly people in China. Objective: To analyze factors influencing health care utilization among middle-aged and elderly people in China. Methods: The study used secondary data from the China Health and Retirement Longitudinal Study (CHARLS) 2013 wave survey. The outcomes of interest include outpatient and inpatient utilization, physical examination and dental care visit. For outpatient and inpatient utilization, the study looked at the choice between public versus private facility. The independent variables are chosen based on the Andersen health care utilization conceptual model. Binary logit is employed as the main estimation method. The study is performed for full sample as well as two sub-samples of the middle-aged and elderly groups. Finally, likelihood ratio test is used to decide whether a full or sub-sample analysis is more appropriate for the data. Furthermore, the magnitude of the impact of each variable on the outcome is interpreted by using marginal effects. Result: For predisposing factors, age has a positive effect on outpatient at public facility, inpatient care and physical examination. Females are more likely to admit and have dental checkup. Higher education attainment has positive effect on getting physical examination and dental care. For enabling factors, those with urban employee basic medical insurance are more likely to use outpatient and inpatient care, and get physical examination. For need factors, people with good self-rated health are less likely to use outpatient, inpatient, physical examination and dental care compared to poor self-rated health counterpart. Conclusions: The increasing demand of health services leads to a shortage of supply, which causes the low accessibility of health care services. In order to cope with this problem, the Chinese government should promote scientific and rational use of health services. Thus, according to evidence from analysis results, the Chinese government must pay attention to factors like health insurance access and reimbursement method, as well as promoting preventive measures to maintain people’s good health, like encouraging socialized and physical exercise.