Healthcare utilization and its association with socioeconomic status in China: Evidence from the 2011–2018 China Health and Retirement Longitudinal Study

Xi Li, Itismita Mohanty, Peipei Chai and Theo Niyonsenga

PLOS ONE, 2024, vol. 19, issue 3, 1-20

Abstract: Introduction: Healthcare utilization often favors the higher-socioeconomic status (SES) and having chronic diseases may exacerbate this inequality. This study aims to examine the trends in health service use over time, the effect of SES on healthcare utilization, and the role of chronic diseases in this association. Methods: Data used in this study were from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, which is the first nationally representative survey of the middle-aged and older. The sample included people aged 45 years and older who responded to all the waves. A total of 10,922 adults were included in this study. Healthcare utilization was categorized into outpatient and inpatient service use and SES was measured by per-capita household expenditure. A multilevel zero-inflated negative binomial regression model was performed to analyze outpatient and inpatient service use, separately. Results: The rates of outpatient service use in 2011, 2013, 2015, and 2018 were 19.11%, 21.45%, 20.12%, and 16.32%, respectively, while the rates of inpatient service use were 8.40%, 13.04%, 14.17%, and 18.79%, respectively. Compared to individuals in the lowest quintile of per-capita household expenditure, those in higher quintiles had higher odds of outpatient service use (Q2: odds ratio = 1.233, p

Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0297025

DOI: 10.1371/journal.pone.0297025

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