Abstract

Based on multidimensional health, we aimed to identify health groups among the elderly Chinese population, and examine its relationship with socio-demographic factors on healthcare utilization. Chinese Longitudinal Healthy Longevity Survey in 2014 was adopted. For 2981 participants aged ≥65 years, without missing any health indicators, latent class analysis was adopted to identify health groups. For 1974 participants with complete information, the two-part model was used to assess how health groups and socio-demographic characteristics influence the outpatient and inpatient expenditure. Four health groups were identified and labeled as “Lacking Socialization” (10.4%), “High Comorbidity” (16.7%), “Severe Disability” (7.8%), and “Relative Health” (65.1%). Compared with the relative health group, the lacking socialization group cost higher inpatient expenditure (p = 0.02). Those in the high comorbidity and severe disability groups were more likely to use healthcare services and cost higher outpatient expenditure (p < 0.01 for all). The effects of socio-demographic factors were also discussed. The findings enhanced our understanding of the heterogeneity of multidimensional health status and complex healthcare demands in the elderly Chinese population. Moreover, it is valuable for improving the allocation of healthcare resource targeted for different groups of the ageing population.

Highlights

  • The ageing population has been one of the major challenges of healthcare services in China

  • We evaluated the effects of health groups, as need factors, and associated socio-demographic factors, as predisposing and enabling factors, on healthcare utilization

  • We examined the heterogeneity of health status among the elderly Chinese based on multidimensional health, and four health groups were delineated using Latent class analysis (LCA)

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Summary

Introduction

The ageing population has been one of the major challenges of healthcare services in China. The increase in the elderly population has led to significant health transitions and extensive utilization of healthcare resources. People are at high risk of suffering from chronic diseases and functional disabilities, and consume the disproportional share of healthcare resources [2,3,4,5]. There is an increasing concern on the complex health status of the growing elderly population and its demand for healthcare services. To compare the differences in the health status of the elderly population, most studies generally considered the indicators involving specific chronic diseases, difficulties with the activities of daily living (ADLs), memory impairments, and so on [5,6,7,8]. According to the World Health Organization (WHO), which defines “health” as a state of complete well-being, synthesized by physical

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