ArticleBMC health services research2018
Age and sex differences in the association between access to medical care and health outcomes among older Chinese.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
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- The effect of urban-rural resident basic medical insurance on physical health of the rural older adult in China.Frontiers in public health · 2024Article
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- Factors Affecting Access to Public Healthcare Facilities in the City of Tshwane, South Africa.International journal of environmental research and public health · 2023Article
- Prevalence, awareness, treatment, and control of dyslipidemia in Chinese adults: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2023Review
- Factors associated with perceived caregivers' willingness to provide care among older adults with disabilities in China.Frontiers in public health · 2023Article
- Factors associated with access to healthcare services for older adults with limited activities of daily living.Frontiers in public health · 2022Article
- The positive association between internal migration and hospitalization among the older adults in China: Regional heterogeneity and chronic disease management.Frontiers in public health · 2022Article
- Identification of Unmet Healthcare Needs: A National Survey in Thailand.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2021Article
- The Influence of Racial Differences in the Demand for Healthcare in South Africa: A Case of Public Healthcare.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether the association between access to medical care and health outcomes differs by age and gender among older adults in China is unclear. We aimed to investigate the associations between self-reported inadequate access to care and multiple health outcomes among older men and women in mainland China.
methodsBased on four latest waves available so far from a national longitudinal study in mainland China in 2005-2014, we used multilevel random-effect logistic models to estimate the contemporaneous relationships between inadequate access to care and disabilities in instrumental activities of daily living (IADL) and cognitive impairment in men and women at ages 65-74, 75-84, 85-94, and 95+, separately. We also used multilevel hazard models to investigate the relationships between reported access to care and mortality in 2005-2014. Nested models were used to adjust for survey design, sociodemographic background, enrollment in health insurance, and health behaviors.
resultsApproximately 6.5% of older adults in China reported inadequate access to care in the period of 2005-2014; and the percentages increased with age and were higher among women at older ages (≥75 years). Overall, older adults with self-reported inadequate access to care had greater odds of IADL and ADL disabilities and cognitive impairment than those with adequate access to healthcare. The elevated odds ratios (ORs) in men were higher in middle-old (75-84) and old-old (85-94) age groups compared to other age groups; whereas the elevated ORs in women were higher in young-old (65-74) and middle-old (75-84) age groups. The relationship between access to care and the health outcomes was generally weakest at the oldest-old ages (95+). Inadequate access to care was also linked with higher mortality risk, primarily in adults aged 75-84, and it was somewhat more pronounced in women than in men.
conclusionsIncreased odds of physical disability and cognitive impairment and increased risk of mortality are linked with inadequate access to care. The associations were generally stronger in women than in men and varied across age groups. The findings of the present study have important implications for further improving access to health care and improving health outcomes of older adults in China.
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