ArticleBMJ global health2022
Multimorbidity and out-of-pocket expenditure for medicines in China and India.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Medicine price and affordability in China and selected ASEAN countries: a cross-country comparison with forward-looking implications for regional pooled procurement.BMC medicine · 2026Article
- Health Shocks and Debt Risk Among Middle-Aged and Elderly Individuals in China: The Mediating Roles of Informal Self-Treatment and Formal Healthcare Utilization.Risk management and healthcare policy · 2026Article
- Multimorbidity and its associations with physical function, fall risk, and hospitalization cost in adults with type 1 diabetes: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Sex- and age-specific multimorbidity networks in middle-aged inpatients: a network-based comparative study between China and the United Kingdom.Innovation in aging · 2025Article
- Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China.Frontiers in public health · 2025Article
- Comorbidity progression analysis: patient stratification and comorbidity prediction using temporal comorbidity network.Health information science and systems · 2024Article
- The Economic Burden of Chronic Diseases with Co-Occurring Depression and Alcohol Use Disorder for People in the Western Cape, South Africa.SSM. Mental health · 2023Article
- Associations among socioeconomic status, multimorbidity of non-communicable diseases, and the risk of household catastrophic health expenditure in China: a population-based cohort study.BMC health services research · 2023Article
- Facilitators and Barriers of Integrated Care for Older Adults with Multimorbidity: A Descriptive Qualitative Study.Clinical interventions in aging · 2023Article
- Functional limitation as a mediator of the relationship between multimorbidity on health-related quality of life in Australia: evidence from a national panel mediation analysis.Frontiers in medicine · 2023Article
- Overview of multimorbidity research in India: A scoping review.Journal of multimorbidity and comorbidityReview
- Non-communicable disease multi-morbidity in policies from India, Thailand, and South Africa: A comparative document review.Journal of multimorbidity and comorbidityArticle
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10 authors.
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Abstract
introductionUsing nationally representative survey data from China and India, this study examined (1) the distribution and patterns of multimorbidity in relation to socioeconomic status and (2) association between multimorbidity and out-of-pocket expenditure (OOPE) for medicines by socioeconomic groups.
methodsSecondary data analysis of adult population aged 45 years and older from WHO Study on Global Ageing and Adult Health (SAGE) India 2015 (n=7397) and China Health and Retirement Longitudinal Study (CHARLS) 2015 (n=11 570). Log-linear, two-parts, zero-inflated and quantile regression models were performed to assess the association between multimorbidity and OOPE for medicines in both countries. Quantile regression was adopted to assess the observed relationship across OOPE distributions.
resultsBased on 14 (11 self-reported) and 9 (8 self-reported) long-term conditions in the CHARLS and SAGE datasets, respectively, the prevalence of multimorbidity in the adult population aged 45 and older was found to be 63.4% in China and 42.2% in India. Of those with any long-term health condition, 38.6% in China and 20.9% in India had complex multimorbidity. Multimorbidity was significantly associated with higher OOPE for medicines in both countries (p<0.05); an additional physical long-term condition was associated with a 18.8% increase in OOPE for medicine in China (p<0.05) and a 20.9% increase in India (p<0.05). Liver disease was associated with highest increase in OOPE for medicines in China (61.6%) and stroke in India (131.6%). Diabetes had the second largest increase (China: 58.4%, India: 91.6%) in OOPE for medicines in both countries.
conclusionMultimorbidity was associated with substantially higher OOPE for medicines in China and India compared with those without multimorbidity. Our findings provide supporting evidence of the need to improve financial protection for populations with an increased burden of chronic diseases in low-income and middle-income countries.
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