ArticleBMJ open2019
Socioeconomic determinants of out-of-pocket pharmaceutical expenditure among middle-aged and elderly adults based on the China Health and Retirement Longitudinal Survey.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Explaining changes in socioeconomic inequality in catastrophic health expenditure in China: a mobility-determinant decomposition.Health economics review · 2026Article
- Factors associated with Traditional Chinese Medicine use among older adults with chronic diseases in China.Scientific reports · 2026Article
- The impact of digital infrastructure construction on the depressive symptoms among middle-aged and older adults: evidence from China.BMC public health · 2026Article
- Assessing the determinants of out-of-pocket health expenditures among Cambodian households in informal employment using survey data.International journal for equity in health · 2025Article
- Out-of-pocket expenditures associated with double disease burden in Pakistan: a quantile regression analysis.BMC public health · 2024Article
- Out-of-pocket pharmaceutical expenditure and its determinants among Iranian households with elderly members: a double-hurdle model.Cost effectiveness and resource allocation : C/E · 2024Article
- Determinants of out-of-pocket expenditure on medicines among adults in Saudi Arabia: a cross-sectional study.Frontiers in medicine · 2024Article
- Population ageing and sustainability of healthcare financing in China.Cost effectiveness and resource allocation : C/E · 2023Review
- Inequality of opportunity in outpatient expenditure among the elderly with multimorbidity: evidence from China.International journal for equity in health · 2023Article
- Factors associated with the incidence and the expenditure of self-medication among middle-aged and older adults in China: A cross-sectional study.Frontiers in public health · 2023Article
- Inequality in Drug Utilization among Chronic Myeloid Leukaemia Patients in Malaysia: A Cost-Utility Analysis.Asian Pacific journal of cancer prevention : APJCP · 2022Article
- Household financial burden associated with healthcare for older people in Viet Nam: a cross-sectional survey.Health research policy and systems · 2022Article
- Self-Medication Behaviors of Chinese Residents and Consideration Related to Drug Prices and Medical Insurance Reimbursement When Self-Medicating: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Does self-medication reduce medical expenditure among the middle-aged and elderly population? A four-wave longitudinal study in China.Frontiers in public health · 2022Article
- Temporal trends and variation in out-of-pocket expenditures and patient cost sharing: evidence from a Chinese national survey 2011-2015.International journal for equity in health · 2021Article
- [Human resource density and inequality in health care spending in the Americas].Revista panamericana de salud publica = Pan American journal of public health · 2020Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOut-of-pocket pharmaceutical expenditure (OOPPE) is a considerable burden for middle-aged and elderly adults due to their high prevalence of diseases, insufficient income and absence of medical insurance in China. The objective of this study was to assess the determinants of OOPPE among Chinese middle-aged and elderly adults.
methodsThis is a cross-sectional study based on the China Health and Retirement Longitudinal Survey conducted in 2015. The Andersen behavioural health model was used to select the factors. Binary multivariable logistic and generalised linear regressions were both applied to examine the determinants of OOPPE.
resultsOf the respondents, 15.28%, 5.20% and 51.35% reported an OOPPE for outpatient services, inpatient services and self-medication, respectively. The OOPPE for outpatient services, inpatient services and self-medication was US$6.66, US$17.93 and US$15.32, respectively. Increased age significantly influenced the likelihood of OOPPE, and older people (aged >65 years) had lower OOPPE for outpatient services. Having health insurance significantly reduced the likelihood of OOPPE for outpatient and inpatient services but increased OOPPE for self-medication. In general, compared with the low-income group, higher income groups had a significantly lower likelihood of having an OOPPE, and when they did the amounts were less. Generally, middle-aged and elderly people with poor self-reported health status, limitation of daily activities, and critical or chronic diseases had a significantly higher likelihood of having an OOPPE and at a significantly higher amount.
conclusionPolicy-making efforts should focus on reducing self-medication OOPPE and alleviating its associated socioeconomic determinants to ease the economic burden of diseases among middle-aged and elderly adults in China.
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