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Inequality and Associated Factors in Utilization of Long-Term Care Among Chinese Older People: Evidence from the Chinese Longitudinal Healthy Longevity Survey

Author

Listed:
  • Zhonghua Wang

    (Nanjing Medical University
    Nanjing Medical University
    Nanjing Medical University)

  • Xue Yang

    (Nanjing Medical University)

  • Mingsheng Chen

    (Nanjing Medical University
    Nanjing Medical University
    Nanjing Medical University)

Abstract

As the world population ages, long-term care (LTC) for the disabled elderly has become an urgent policy issue facing countries around the world. This study aims to analyze the determinants and inequalities in the utilization of different home- and institution-based LTC services in China. Using data from the Chinese Longitudinal Healthy Longevity Survey, we established a multinomial logit regression model based on the Andersen’s healthcare utilization model as a framework to identify the related factors. A concentration index and its decomposition were then adopted to measure the inequalities and decompose their major contributors in the utilization of LTC. The results show that all enabling factors, some need factors (limitations in activities of daily living and instrumental activities of daily living), and some predisposing factors (age, gender) significantly affected home-and institution-based care use. Evidence of inequalities in LTC use was found among Chinese elderly. Specifically, use of institution-based care was concentrated among rich people, while use of home-based care was concentrated among poor people. Some socioeconomic factors were major contributors to LTC inequality. Major contributors of inequality differed between users of home or institutional care. Strategies aimed at reducing inequality of LTC services should address related socioeconomic factors and major contributors.

Suggested Citation

  • Zhonghua Wang & Xue Yang & Mingsheng Chen, 2022. "Inequality and Associated Factors in Utilization of Long-Term Care Among Chinese Older People: Evidence from the Chinese Longitudinal Healthy Longevity Survey," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 467-486, April.
  • Handle: RePEc:spr:soinre:v:160:y:2022:i:2:d:10.1007_s11205-020-02279-x
    DOI: 10.1007/s11205-020-02279-x
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    References listed on IDEAS

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    1. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & Vincenzo Carrieri & Cinzia Di Novi & Cristina Elisa Orso, 2017. "Home Sweet Home? Public Financing and Inequalities in the Use of Home Care Services in Europe," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 445-468, September.
    2. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    3. Daisy Duell & Xander Koolman & France Portrait, 2017. "Practice variation in the Dutch long‐term care and the role of supply‐sensitive care: Is access to the Dutch long‐term care equitable?," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1728-1742, December.
    4. Hu, Bo, 2019. "Projecting future demand for informal care among older people in China: the road towards a sustainable long-term care system," Health Economics, Policy and Law, Cambridge University Press, vol. 14(1), pages 61-81, January.
    5. Ricardo Rodrigues & Stefania Ilinca & Andrea E. Schmidt, 2018. "Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 637-646, March.
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