ArticleBMC medical research methodology2022
Multi-dimensional vulnerability analysis on catastrophic health expenditure among middle-aged and older adults with chronic diseases in China.
Article in BMC medical research methodology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Understanding variation in catastrophic health expenditure from socio-ecological aspect: a systematic review.BMC public health · 2024Pooled it
- Association between multimorbidity and childhood socioeconomic status with depressive symptoms among middle-aged and older adults in rural western China.Scientific reports · 2026Article
- Resource endowment, medical services utilization and health poverty vulnerability: evidence from middle-aged and older households in rural western China.Frontiers in public health · 2026Article
- Study on Chinese patients' views on endometriosis surgery and fertility preservation in the context of declining fertility.BMC women's health · 2025Article
- Chronic diseases and catastrophic health expenditures in elderly Chinese households: a cohort study.BMC geriatrics · 2025Article
- Health beliefs mediates the association between the number of non-communicable diseases and preventive behaviors in middle-aged and older adults in southern China.Aging clinical and experimental research · 2025Article
- Prevalence and correlates of anxiety and depression among chronically ill older adults in Zunyi, China: a cross-sectional study.Frontiers in psychology · 2025Article
- Article
- Catastrophic health expenditure associated with non-inpatient costs among middle-aged and older individuals in China.Frontiers in public health · 2024Article
- Psychological resilience and quality of life among middle-aged and older adults hospitalized with chronic diseases: multiple mediating effects through sleep quality and depression.BMC geriatrics · 2023Article
- Regional catastrophic health expenditure and health inequality in China.Frontiers in public health · 2023Article
- How to Make Primary Healthcare More Popular: Evidence from the Middle-Aged and Elderly in China.Healthcare (Basel, Switzerland) · 2022Article
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Authors and funding
18 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMiddle-aged and older adults are more likely to suffer from chronic diseases because of their particular health characteristics, which lead to a high incidence of catastrophic health expenditure (CHE). This study plans to analyse the different factors affecting CHE in middle-aged and older adults with chronic diseases, target the vulnerable characteristics, and suggest groups that medical insurance policies should pay more attention to.
methodsThe data used in this study came from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database. The method of calculating the CHE was adopted from the World Health Organization (WHO). The logistic regression was used to determine the family characteristics of chronic disease in middle-aged and older adults with a high probability of incurring CHE.
resultsThe incidence of CHE in middle-aged and older adults with chronic disease was highest in sub-poverty level families (26.20%) was lowest in wealthier level families (20.07%). Households with malignant tumours had the highest CHE incidence under any circumstances, especially if the householder had been using inpatient service in the past year. Among the comparison of CHE incidence in different types of medical insurance, the Urban and Rural Residents' Basic Medical Insurance (URRBMI) was the highest (27.46%). The incidence of CHE was 2.73 times (95% CI 2.30-3.24) and 2.16 times (95% CI 1.81-2.57) higher among people who had used inpatient services in the past year or outpatient services in the past month than those who had not used them.
conclusionsRelatively wealthy economic conditions cannot significantly reduce the financial burden of chronic diseases in middle-aged and older adults. For this particular group with multiple vulnerabilities, such as physical and social vulnerability, the high demand and utilization of health services are the main reasons for the high incidence of CHE. After achieving the goal of lowering the threshold of universal access to health services, the medical insurance system in the next stage should focus on multiple vulnerable groups and strengthen the financial protection for middle-aged and older adults with chronic diseases, especially for patients with malignant tumours.
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