Abstract
Background: As China embraced an aging society, the burden of age-related diseases had increased dramatically. Knowledge about spatial distribution characteristics of disease burden and the influencing factors of medical expenditure is of great significance to the formulation of health policies. However, related research in rural China is still insufficient.Methods: A total of 5,744,717 records of hospitalized rural elderly in southeast China were collected from 2010 to 2016. We described the temporal trends of hospitalization medical expenditure and the prevalence of catastrophic health expenses (CHE) in the rural elderly by common diseases. Then, geographical information tools were used for visualization of geographic distribution patterns of CHE, the ordinary least squares methods (OLS) and geographically weighted regression (GWR) were employed to examine the influencing factors of medical expenditure.Results: The number of CHE hospitalizations and the total number of hospitalizations for the rural elderly people increased by 2.1 times and 2.2 times, respectively, from 2010 to 2016. Counties with a high prevalence of CHE were clustered in the eastern coastal area (Moran's I = 0.620, P < 0.001, General G < 0.001, P < 0.001). Unspecified transport accidents, cardiovascular disease, and essential hypertension were the top causes of CHE in the rural elderly. Adequate hospital beds (P < 0.05) and reasonable utilization and distribution of town-level (P < 0.001) and county-level hospitals (P < 0.001) may help reduce medical expenditures.Conclusions: In the context of an aging society, the disease burden for the elderly in rural areas should arouse more attention. These findings highlight the importance of age-related disease prevention and the rational allocation of medical resources in rural areas.
Highlights
China is the country with the largest population and the largest number of older adults in the world, who began to embrace an aging society in 1999, is one of the first developing countries to enter an aging society
The data of inpatients was extracted from the New Rural Cooperative Medical Scheme (NRCMS) in the Fujian province, a representative coastal province with about a population of 39 million and a land area of 121,400 km2 in southeast China
The previous study indicated that China had accomplished nearly universal insurance coverage, the enrolment rate of NRCMS among rural residents had reached 96.6% in 2010 [14]
Summary
China is the country with the largest population and the largest number of older adults in the world, who began to embrace an aging society in 1999, is one of the first developing countries to enter an aging society. As the population is growing and aging, the age-related disease burden is rising rapidly. In the past two decades, the causes of disease burden in China have changed dramatically. Stroke and ischemic heart disease were the leading causes of death and disability-adjusted life-years (DALYs). Past research indicates that the aging problem was worse, and the burden of disease was higher in rural China [3, 4]. In China, less research has been done to compare common disease burden for the rural elderly. As China embraced an aging society, the burden of age-related diseases had increased dramatically. Knowledge about spatial distribution characteristics of disease burden and the influencing factors of medical expenditure is of great significance to the formulation of health policies.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
