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

Corresponding author: wangzhonghua, wzh04@njmu.edu.cn

DOI: 10.12201/bmr.202406.00025

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  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

  Submit time: 17 June 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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