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Long-Term Services and Supports and Disease Management among Older Chinese Adults in Different Stages of Cognitive Impairment

Author

Listed:
  • Lin, Zhuoer

    (University of Illinois Chicago)

  • Chen, Xi

    (Yale University)

Abstract

Rapid population aging elevates burden of chronic and non-communicable diseases among older adults. Despite the critical role of self-management in disease prevention and control, effective management of diseases can be cognitively demanding and may require additional supports from family and social services. Using nationally representative data from China, this paper reveals great challenges in disease management and characterizes the differential effects of long-term care services and supports (LTSS) on disease management among older adults in different stages of cognitive impairment (CI). In specific, we use preventive care utilization and hypertension management as key indicators to assess the performance of disease management. We show that while access to LTSS from spouse or home-based services significantly facilitate active disease management behaviors, the effects are only evident among older adults with no CI. By contrast, access to LTSS has very modest effect for cognitively impaired individuals. In addition, older adults in more severe stages of CI perform worse in disease prevention, hypertension awareness and management. These findings reveal the vulnerability of older adults with CI in disease management and point to the importance of promoting targeted interventions to reduce barriers of accessing LTSS, especially among cognitively impaired population.

Suggested Citation

  • Lin, Zhuoer & Chen, Xi, 2022. "Long-Term Services and Supports and Disease Management among Older Chinese Adults in Different Stages of Cognitive Impairment," IZA Discussion Papers 15471, IZA Network @ LISER.
    • Handle: RePEc:iza:izadps:dp15471
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    References listed on IDEAS

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    1. Xiao Xu & Jersey Liang & Joan M. Bennett & Anda Botoseneanu & Heather G. Allore, 2015. "Editor's choice Socioeconomic Stratification and Multidimensional Health Trajectories: Evidence of Convergence in Later Old Age," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 70(4), pages 661-671.
    2. Sohn, Minsung & O'Campo, Patricia & Muntaner, Carles & Chung, Haejoo & Choi, Mankyu, 2020. "Has the long-term care insurance resolved disparities in mortality for older Koreans? examination of service type and income level," Social Science & Medicine, Elsevier, vol. 247(C).
    3. Yaohui Zhao & Eileen M. Crimmins & Peifeng Hu & Yang Shen & James P. Smith & John Strauss & Yafeng Wang & Yuan Zhang, 2016. "Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(3), pages 347-356, April.
    4. Lin, Zhuoer & Chen, Xi, 2021. "Adverse Childhood Circumstances and Cognitive Function in Middle-Aged and Older Chinese Adults: Lower Level or Faster Decline?," IZA Discussion Papers 14161, IZA Network @ LISER.
    5. Andrea Wysocki & Mary Butler & Robert L. Kane & Rosalie A. Kane & Tetyana Shippee & François Sainfort, 2015. "Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care," Mathematica Policy Research Reports 30503869a2a744d387ea9ac13, Mathematica Policy Research.
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    Cited by:

    1. Guo, Miao & Li, Yang & Zhang, Wendan, 2025. "Supply expansion of Long-Term Services & Supports: Evidence from China’s long-term care insurance pilot," Journal of Economic Behavior & Organization, Elsevier, vol. 239(C).
    2. Dhingra, Aarushi & Fiorentini, Gianluca & Connelly, Luke, 2025. "The impact of individuals’ preventive behaviours on health and healthcare utilisation," Economics & Human Biology, Elsevier, vol. 57(C).

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    JEL classification:

    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • D10 - Microeconomics - - Household Behavior - - - General
    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods

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