Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?
Abstract
:1. Introduction
1.1. Background: The Current Health Insurance System in China
1.2. Conceptual Framework
1.3. Health Insurance and Outpatient Visits
1.4. City of Residence and Outpatient Visits
1.5. Current Study
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. Outpatient Visits
2.2.2. Health Insurance and City of Residence
2.2.3. Covariate Variables
2.3. Statistical Analysis
3. Results
3.1. Socio-Demographic Characteristics of the Respondents
3.2. Health Insurance and City of Residence by Outpatient Visits
3.3. Logistic Regression Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | n (%) | M (SD) |
---|---|---|
Health insurance | ||
No health insurance | 543 (17.11) | |
Urban resident medical insurance | 831 (26.19) | |
Urban employee medical insurance | 1660 (52.32) | |
Public medical insurance | 139 (4.38) | |
Cityof residence | ||
Chengdu | 503 (15.85) | |
Hohhot | 545 (17.18) | |
Guangzhou | 585 (18.44) | |
Dalian | 776 (24.46) | |
Shanghai | 764 (24.08) | |
Predisposing characteristics | ||
Gender | ||
Female | 2198 (69.27) | |
Male | 975 (30.73) | |
Age | 78.978 (5.556) [70, 107] | |
Marital status | ||
Unmarried | 2605 (82.10) | |
Married | 568 (17.90) | |
Education | ||
Illiterate | 812 (25.59) | |
Primary school or higher | 2361 (74.41) | |
Enabling factors | ||
Self-reported financial status | 3.113 (0.843) [1, 5] | |
Number of children | 2.657 (1.403) [0, 9] | |
Need factors | ||
Self-rated health status | 3.003 (1.068) [1, 5] | |
Functional limitations | ||
No functional limitations | 2410 (75.95) | |
Some functional limitations | 763 (24.05) | |
Number of chronic diseases | 1.845 (1.215) [0, 10] |
Variables | Outpatient Visits n (%) | p-Value | |
---|---|---|---|
Yes (n = 1648) | No (n = 1525) | ||
Health insurance | <0.001 | ||
No health insurance | 213 (39.23) | 330 (60.77) | |
Urban resident basic medical insurance | 439 (52.83) | 392 (47.17) | |
Urban employee basic medical insurance | 916 (55.18) | 744 (44.82) | |
Public medical insurance | 80 (57.55) | 59 (42.45) | |
Cityof residence | <0.001 | ||
Chengdu | 262 (52.09) | 241 (47.91) | |
Hohhot | 194 (35.60) | 351 (64.40) | |
Guangzhou | 395 (67.52) | 190 (32.48) | |
Dalian | 281 (36.21) | 495 (63.79) | |
Shanghai | 516 (67. 54) | 248 (32.46) |
Variables | Model 1 | Model 2 |
---|---|---|
OR (95% CI) | OR (95% CI) | |
Health insurance (ref = no insurance) | ||
Urban resident basic medical insurance | 1.327 (1.026–1.715) | 1.226 (0.942–1.595) |
Urban employee basic medical insurance | 1.394 (1.098–1.771) | 1.212 (0.948–1.549) |
Public medical insurance | 2.060 (1.332–3.186) | 1.752 (1.121–2.739) |
Cityof residence (ref = Chengdu) | ||
Hohhot | 0.434 (0.325–0.579) | 0.331 (0.244–0.447) |
Guangzhou | 2.423 (1.847–3.179) | 2.450 (1.857–3.232) |
Dalian | 0.599 (0.464–0.773) | 0.560 (0.431–0.728) |
Shanghai | 2.396 (1.855–3.094) | 2.402 (1.848–3.123) |
Predisposing characteristics | ||
Male (ref = female) | 0.825 (0.689–0.987) | 0.866 (0.721–1.040) |
Age | 0.983 (0.967–0.999) | 0.982 (0.966–0.998) |
Married (ref = Unmarried) | 1.142 (0.920–1.417) | 1.107 (0.889–1.378) |
Primary school or higher (ref = Illiterate) | 1.228 (1.012–1.490) | 1.207 (0.990–1.472) |
Enabling factors | ||
Self-reported financial status | 0.932 (0.839–1.034) | 0.944 (0.849–1.050) |
Number of children | 1.101 (1.036–1.169) | 1.090 (1.025–1.159) |
Need factors | ||
Self-rated health status | 0.494 (0.452–0.540) | 0.596 (0.542–0.655) |
Some functional limitations (ref = no) | 1.351 (1.097–1.664) | 1.284 (1.038–1.588) |
Number of chronic diseases | 1.572 (1.448–1.708) | |
R2 | 0.1606 | 0.1893 |
Log likelihood | −1844.2034 | −1781.1909 |
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Wang, J.; Pei, Y.; Zhong, R.; Wu, B. Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter? Int. J. Environ. Res. Public Health 2020, 17, 4256. https://doi.org/10.3390/ijerph17124256
Wang J, Pei Y, Zhong R, Wu B. Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter? International Journal of Environmental Research and Public Health. 2020; 17(12):4256. https://doi.org/10.3390/ijerph17124256
Chicago/Turabian StyleWang, Jianyun, Yaolin Pei, Renyao Zhong, and Bei Wu. 2020. "Outpatient Visits among Older Adults Living Alone in China: Does Health Insurance and City of Residence Matter?" International Journal of Environmental Research and Public Health 17, no. 12: 4256. https://doi.org/10.3390/ijerph17124256