通讯作者: 王中华, wzh04@njmu.edu.cn

DOI：10.12201/bmr.202406.00025

Study on Catastrophic Health Expenditure and Its Inequality among Elderly Household in China：Empirical Analysis Based on CFPS Data

• 摘要：目的：测算我国高龄老人家庭灾难性卫生支出发生现状,分析灾难性卫生支出不平等趋势及贡献因素,为减少灾难性卫生支出发生、降低老年家庭财务风险提供参考依据。方法:基于中国家庭追踪调查(China Family Panel Studies,CFPS)2012、2016、2018和2020年数据,测算高龄老人家庭灾难性卫生支出发生率和发生强度及变化趋势,利用Logit回归、多元线性回归估计灾难性卫生支出的影响因素,运用集中指数及其分解方法分析灾难性卫生支出不平等及相关因素贡献度。结果:2012年、2016年、2018年及2020年的灾难性卫生支出发生率分别为24.61%、21.99%、23.69%和12.9%,平均差距分别为0.0616、0.0506、0.0524和0.0340,相对差距为0.2505、0.2303、0.2212和0.2633,灾难性卫生支出发生率的集中指数分别为－0.0707、－0.1172、－0.2279和-0.3084,发生强度的集中指数分别为－0.1786、－0.1153、-0.2763和－0.2976,存在倾向于低收入家庭的不平等。经济(家庭存款、家庭人均收入、家庭净资产)状况、老人身体健康程度、老人拥有组织成员身份是灾难性卫生支出不平等的主要正向贡献因素,伴侣健在对灾难性卫生支出不平等有一定负向贡献。结论:中国高龄老人家庭灾难性卫生支出发生风险较高、强度较大,且不平等趋势加剧。制定政策时可将相关不平等的贡献因素纳入考虑,为高龄老人群体提供相应的经济风险保护。

  关键词： 高龄老人; 灾难性卫生支出; 集中指数

   

  Abstract: Objective: This study aims to assess the current status of catastrophic health expenditure (CHE) among elderly households in China, analyze the evolving inequality trends of CHE, and identify the contributing factors. The primary goal is to offer a foundational framework for reducing the prevalence of CHE and alleviating the financial burdens faced by elderly households. Methods: Utilizing data from the China Family Panel Studies (CFPS) conducted in 2012, 2016, 2018, and 2020, we calculated the incidence rate and severity of CHE for elderly households. We employed logit regression and multiple linear regression analyses to estimate the factors influencing CHE. Furthermore, we utilized the concentration index (CI) and its decomposition method to examine the disparities in CHE and the respective impacts of associated factors. Results: The incidence rates of CHE in 2012, 2016, 2018, and 2020 were 24.61%, 21.99%, 23.69%, and 12.9%, respectively. The average gaps in CHE were 0.0616, 0.0506, 0.0524, and 0.0340, with relative gaps of 0.2505, 0.2303, 0.2212, and 0.2633. The concentration index (CI) for the incidence of CHE was -0.0707, -0.1172, -0.2279, and -0.3084, while the CI for the intensity of CHE was -0.178?6, -0.1153, -0.2763, and -0.2976, respectively. Inequity disproportionately harms low-income households, with economic indicators such as household savings, per capita income, and net assets, as well as elderly health and engagement in organizational activities, playing significant roles in exacerbating the disparity in CHE. Furthermore, the presence of a partner has been identified as a mitigating factor in these trends. Conclusion：Our findings suggest that the prevalence of CHE is elevated among elderly households in China, with a widening gap in inequality. It is imperative for the government to acknowledge the impact of this inequality and implement targeted interventions to safeguard elderly households from economic vulnerabilities.

  Key words: Elderly people; Catastrophic health expenditure; The concentration index

  提交时间：2024-06-17

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• 序号	提交日期	编号	操作
  1	2024-03-25	bmr.202406.00025V1	下载

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