Impact of pension income on healthcare utilization of older adults in rural China

International Journal for Equity in Health

Research

Stephen Nicholas¹  Chen Chen²  Fenghang Li³  Jialong Tan³  Peizhe Yan³  Jian Wang⁴  Elizabeth Maitland⁵ 

[1] Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, NSW, Australia;Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia;Department of Global Health, School of Public Health, Wuhan University, Hubei Province, 115 Donghu Road, 430079, Wuhan, China;Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China;Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China;Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Hubei Province, Room A201, 430079, Wuhan, China;School of Management, University of Liverpool, Liverpool, England;

关键词: New Rural Pension Scheme;    Income shock;    Healthcare utilization;    Rural residents;    Over-the-counter drug;   

DOI  :  10.1186/s12939-023-01985-5

 received in 2023-02-28, accepted in 2023-08-10,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveIn China, rural residents experience poorer health conditions and a higher disease burden compared to urban residents but have lower healthcare services utilization. Rather than an insurance focus on enhanced healthcare services utilization, we aim to examine that whether an income shock, in the form of China’s New Rural Pension Scheme (NRPS), will affect outpatient, inpatient and discretionary over-the-counter drug utilization by over 60-year-old rural NRPS residents.MethodsProviding a monthly pension of around RMB88 (USD12.97), NRPS covered all rural residents over 60 years old. Fuzzy regression discontinuity design (FRDD) was employed to explore the NRPS causal effect on healthcare services utilization, measured by outpatient and inpatient visits and discretionary over-the-counter drug purchases. The nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 provided the data.ResultsWithout significant changes in health status and medication needs, 60-plus-year-old NRPS recipients significantly increased the probability of discretionary OTC drug purchases by 33 percentage points. NRPS had no significant effect on the utilization of outpatient and inpatient utilization. The increase in the probability of discretionary OTC drug purchases from the NRPS income shock was concentrated in healthier and low-income rural residents. Robustness tests confirmed that FRDD was a robust estimation method and our results are robust.ConclusionNRPS was an exogenous income shock that significantly increased the probability of discretionary over-the-counter drug purchases among over 60-year-old rural residents, but not the utilization of inpatient or outpatient healthcare services. Income remains an important constraint for rural residents to improve their health. We recommend policymakers consider including commonly used over-the-counter drugs in basic health insurance reimbursements for rural residents; provide health advice for rural residents to make discretionary over-the-counter drug purchases; and to mount an information campaign on over-the-counter drug purchasing in order to increase the health awareness of rural residents.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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