Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2015

Open Access 01-12-2015 | Research Article

Health care utilization in older people with cardiovascular disease in China

Authors: Lixia Dou, Xiaoyun Liu, Tuohong Zhang, Yangfeng Wu

Published in: International Journal for Equity in Health | Issue 1/2015

Login to get access

Abstract

Background

Population is ageing rapidly and prevalence of cardiovascular diseases is increasing in China. This study aims to examine the patterns of outpatient and inpatient health care utilization across different demographic and socioeconomic groups in older people with cardiovascular disease in China.

Methods

Data were from World Health Organization (WHO) Study on Global Aging and Adult Health (SAGE) Wave 1. Chinese older people aged over 50 years with cardiovascular disease were included in the analysis. Outpatient and inpatient care utilization rates were presented and compared by demographic and socioeconomic characteristics. Multivariable logistic regression was used to examine the association between socioeconomic factors and health care utilization.

Results

In total, 4162 older people with cardiovascular disease in SAGE China Wave 1 were included in the analysis. 86.4 % of them had health insurance. 54.9 % of the patients received outpatient care and 17.7 % received inpatient care over the past 12 months. Outpatient care utilization rate was significantly associated with age. Patients in older groups used more outpatient care than those in younger groups (p = 0.010). Inpatient care utilization rate peaked at 70–79 years group (23.2 %), and then reduced to 17.5 % in 80 years plus group. Rich patients used more outpatient service than the poorer (p < 0.001). No association was found between household wealth status and inpatient service utilization.

Conclusion

Within the context of high health insurance coverage in China, the pattern of outpatient care utilization differs from that of inpatient care utilization among older patients aged over 50 years old with cardiovascular disease. Patients tend to use more outpatient care as they became older. As for inpatient care, the oldest patients aged over 80 years use less inpatient care than the 70–79 group. Household economic status plays an important role in outpatient care utilization, but it shows no association with inpatient care utilization in Chinese older patients.
Literature
1.
National Bureau of Statistics of China. Sixth National Population Census of the People’s Republic of China. Beijing: National Bureau of Statistics of China; 2011.
2.
3.
4.
Peltzer K, Williams JS, Kowal P, Negin J, Snodgrass JJ, Yawson A, et al. Universal health coverage in emerging economies: findings on healthcare utilization by older adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa. Glob Health Action. 2014;7:25314. doi:10.​3402/​gha.​v7.​25314.PubMed
5.
Gao J, Qian J, Tang S, Eriksson B, Blas E. Health equity in transition from planned to market economy in China. Health Policy Plan. 2002;17 Suppl 1:20–9.PubMedCrossRef
6.
Guo Y, Shibuya K, Cheng G, Rao K, Lee L, Tang S. Tracking China’s health reform. Lancet. 2010;375:1056–8.PubMedCrossRef
7.
Meng Q. Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study. Lancet. 2012;379:805–14.PubMedCrossRef
8.
Jian W, Chan KY, Reidpath DD, Xu L. China’s rural–urban care gap shrank for chronic disease patients, but inequities persist. Health Aff. 2010;29:2189–96.CrossRef
9.
Sun Q, Liu X, Meng Q, Tang S, Yu B, Tolhurst R. Evaluating the financial protection of patients with chronic disease by health insurance in rural China. Int J Equity Health. 2009;8:42.PubMedCentralPubMedCrossRef
10.
11.
Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Lopez Ridaura R, et al. Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE). Int J Epidemiol. 2012;41:1639–49.PubMedCentralPubMedCrossRef
12.
Lloyd-Sherlock P, Beard J, Minicuci N, Ebrahim S, Chatterji S. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control. Int J Epidemiol. 2014;43:116–28.PubMedCentralPubMedCrossRef
13.
Writing Group of 2010 Chinese Guidelines for the Management of Hypertension. 2010 Chinese guidelines for the management of hypertension. Chin J Hypertens. 2011;19:701–43.
14.
Chinese Society of Cardiology, Chinese Medical Association; Editorial Board, Chinese Journal of Cardiology. Guideline for diagnosis and treatment of patients with chronic stable angina. Chin J Cardiol. 2007;35:195–206.
15.
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160–236.PubMedCrossRef
16.
Umscheid CA, Gross R, Weiner MG, Hollenbeak CS, Tang SSK, Turner BJ. Racial disparities in hypertension control, but not treatment intensification. Am J Hypertens. 2010;23:54–61.PubMedCrossRef
17.
Elwell-Sutton TM, Jiang CQ, Zhang WS, Cheng KK, Lam TH, Leung GM, et al. Inequality and inequity in access to health care and treatment for chronic conditions in China: the Biobank Cohort Study. Health Policy Plan. 2013;28:467–79.PubMedCrossRef
18.
Doblhammer G, Kytir J. Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Soc Sci Med. 2001;52:385–91.PubMedCrossRef
19.
Hessler RM, Eriksson BG, Dey D, Steen G, Sundh V, Steen B. The compression of morbidity debate in aging: an empirical test using the gerontological and geriatric population studies in Go ¨teborg, Sweden (H70). Arch Gerontol Geriatr. 2003;37:213–22.PubMedCrossRef
20.
Krupnick A, Alberini A, Cropper M, Simon N, O’Brien B, Goeree R, et al. Age, health and the willingness to pay for mortality risk reductions: a contingent valuation survey of Ontario Residents. J Risk Uncertainty. 2002;24:161–86.CrossRef
21.
Albanese E, Liu Z, Acosta D, Guerra M, Huang Y, Jacob KS, et al. Equity in the delivery of community healthcare to older people: findings from 10/66 Dementia Research Group crosssectional surveys in Latin America, China, India and Nigeria. BMC Health Serv Res. 2011;11:153.PubMedCentralPubMedCrossRef
22.
Redondo-Sendino A, Guallar-Castillo’n P, Banegas JR, Rodriguez-Artalejo F. Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health. 2006;6:155.PubMedCentralPubMedCrossRef
23.
Suh GH. Predictors of mortality in an aging community-based cohort in Korea. Psychogeriatr. 2006;6:10–8.CrossRef
24.
Subramanian SV, Nandy S, Irving M, Gordon D, Lambert H, Davey SG. The mortality divide in India: the differential contributions of gender, caste, and standard of living across the life course. Am J Public Health. 2006;96:818–25.PubMedCentralPubMedCrossRef
25.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pract. 2000;49:147–52.PubMed
26.
Roy K, Chaudhuri A. Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India. Soc Sci Med. 2008;66:1951–63.PubMedCrossRef
27.
Sigfrid LA, Turner C, Crook D, Ray S. Using the UK primary care Quality and Outcomes Framework to audit health care equity: preliminary data on diabetes management. J Public Health. 2006;28:221–5.CrossRef
28.
Li Y, Chi I. Correlates of physician visits among older adults in China: the effects of family support. J Aging Health. 2011;23:933–53.PubMedCrossRef
29.
Yip W, Hsiao WC. Non-evidence-based policy: how effective is China’s new cooperative medical scheme in reducing medical impoverishment? Soc Sci Med. 2009;68:201–9.PubMedCrossRef
Metadata
Title
Health care utilization in older people with cardiovascular disease in China
Authors
Lixia Dou
Xiaoyun Liu
Tuohong Zhang
Yangfeng Wu
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-015-0190-y

Other articles of this Issue 1/2015

International Journal for Equity in Health 1/2015 Go to the issue

Research

Trends and protective factors of female genital mutilation in Burkina Faso: 1999 to 2010

Erratum

Erratum: Lessons from sexual and reproductive health voucher program design and function: a comprehensive review

Research

A cross-sectional study of socio-demographic factors associated with patient access to primary care in Slovenia

Research

The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022: differential associations by sex

Research

Determinants of immunization inequality among urban poor children: evidence from Nairobi’s informal settlements

Research Article

Complicating the dominant morality discourse: mothers and fathers’ constructions of substance use during pregnancy and early parenthood