Abstract
BackgroundPopulation 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.MethodsData 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.ResultsIn 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.ConclusionWithin 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.
Highlights
Population is ageing rapidly and prevalence of cardiovascular diseases is increasing in China
Gender, household wealth status and health insurance were associated with the outpatient care utilization, while only age and health insurance status had an association with the inpatient care utilization
Age is positively associated with outpatient care utilization, whereas in regard to inpatient care, the oldest patients aged over 80 years use limited inpatient services according to their needs
Summary
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. The proportion of older people aged over 60 years reached 13.3 % in 2010 [1]. Prevalence of cardiovascular disease, including hypertension, stroke and angina, is increasing, partially due to urbanization and lifestyle changes. In 2010, the prevalence of self-reported hypertension, angina and stroke has reached 26.7, 7.9 and 3.1 %, respectively, in Chinese older people aged 50 years and over [3].
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