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2018 Conference Presentation

National systems China

12 September 2018

Understanding non-medical costs for health care: evidence from inpatient care for older people in China

Wei Yang, King's College London, United Kingdom


Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. Older people from low socioeconomic groups often find it difficult to meet these costs. This paper examines the effects of non-medical costs on inpatient care and how these costs affect catastrophic health payments and health payment-induced poverty among older people in rural China. Data were drawn from the China Health and Retirement Longitudinal Survey (CHARLS) 2015. The findings suggest that non-medical costs can account for a significantly higher proportion of overall inpatient costs for people aged 60 and above compared to people aged 45 to 59. The travel distance to the health facilities are approximately 74km greater for those who seek care outside his/her county/city compared to those who seek care within the county/city. These long journeys are also associated with greater inpatient medical costs and non-medical costs. The study also suggests that more older people incur catastrophic health payments and suffer from health payment-induced poverty if non-medical costs are included in the inpatient costs. Such effects are more concentrated among the poor than the rich. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving the benefit packages of social health insurance for older people living in rural China as well as strengthening rural health and long-term care systems.

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