How and to what extent can pensions facilitate increased use of health services by older people: evidence from social pension expansion in rural China.

dc.contributor.author

Chen, Shanquan

dc.contributor.author

Chen, Xi

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Law, Stephen

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Lucas, Henry

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Tang, Shenlan

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Long, Qian

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Xue, Lei

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Wang, Zheng

dc.date.accessioned

2024-09-01T15:36:21Z

dc.date.available

2024-09-01T15:36:21Z

dc.date.issued

2020-11

dc.description.abstract

Background

The proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this context, a significant practical issue is how to encourage older people to use the health services they need. This study aims to evaluate the effects of pensions on older adults' health service utilization, and estimate the level of pension required to influence such utilization.

Methods

Using data from a nationally representative sample survey, the China Health and Retirement Longitudinal Study, we adopted a fuzzy regression discontinuity design and undertook segmented regression analysis.

Results

It was found that a pension did encourage low-income people to use both outpatient (OR = 1.219, 95% 1.018-1.460) and inpatient services (OR = 1.269, 95% 1.020-1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037-1.407; OR = 1.206, 95% 1.024-1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094-1.932; OR = 1.456, 95% 1.079-1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote health service utilization were mainly located in the range 55-95 CNY (7.1-12.3 EUR or 8.0-13.8 USD).

Conclusions

A pension was found to have mixed effects on health service utilization for different income groups. Our study enriches existing evidence on the impact of pensions on healthcare-seeking behaviour and can be helpful in policy design and the formulation of improved models relating to pensions and healthcare utilisation.
dc.identifier

10.1186/s12913-020-05831-0

dc.identifier.issn

1472-6963

dc.identifier.issn

1472-6963

dc.identifier.uri

https://hdl.handle.net/10161/31445

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

BMC health services research

dc.relation.isversionof

10.1186/s12913-020-05831-0

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

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Longitudinal Studies

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Retirement

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Aged

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Aged, 80 and over

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Middle Aged

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Pensions

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Health Services

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China

dc.title

How and to what extent can pensions facilitate increased use of health services by older people: evidence from social pension expansion in rural China.

dc.type

Journal article

duke.contributor.orcid

Tang, Shenlan|0000-0001-6462-753X

pubs.begin-page

1008

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1

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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University Institutes and Centers

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Duke Global Health Institute

pubs.organisational-group

Population Health Sciences

pubs.publication-status

Published

pubs.volume

20

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