scholarly journals Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the elderly population?

2020 ◽  
Author(s):  
Nianshi Wang ◽  
Ye Li ◽  
Meiyan Ma ◽  
Mingli Jiao ◽  
Qunhong Wu ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
Elderly Population ◽  
Rural China ◽  
The Elderly ◽  
Catastrophic Health Expenditure ◽  
Rural Elderly ◽  
Vulnerable Groups ◽  
Medical Expense ◽  
Out Of Pocket Payments ◽  
Education Levels

Abstract BACKGROUND : Based on the health poverty alleviation policy, we explored whether the New Rural Cooperative Medical System (NRCMS) had effectively reduced the economic burden of the rural elderly population and impoverished vulnerable groups with regard to medical expenses, providing further evidence for increasing the medical insurance system. METHODS: Data were obtained from the 2015 China Health and Retirement Longitudinal Study. The method was adapted from WHO to calculate the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME). The treatment effect model was used to identify the determinants of CHE in the rural elderly residents. RESULTS: The incidence of CHE in rural China for the elderly is 19.65%, and the impoverishment by medical expense has reached 6.94%. The households enrolled in NRCMS suffered higher CHE (21.9%) and IME (8.0%), than unenrolled households (20.6%, 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with 3 chronic diseases, inpatients, or adults over 65, Risk factors for CHE included education levels, households with inpatients, people over 65 years old, disabilities, and so on. CONCLUSIONS: Although the NRCMS had reduced barriers to the use of household health services while reducing their out of pocket payments, in some respects, it was still not effective to reduce the risk of residents falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and are at risk of falling into poverty through health impoverishment.

scholarly journals Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nianshi Wang ◽  
Jing Xu ◽  
Meiyan Ma ◽  
Linghan Shan ◽  
Mingli Jiao ◽  
...  
Keyword(s):  
Elderly People ◽  
Poverty Alleviation ◽  
Rural China ◽  
Catastrophic Health Expenditure ◽  
World Health ◽  
Vulnerable Groups ◽  
Middle Aged ◽  
Medical Expense ◽  
Out Of Pocket Payments ◽  
Health Organization

Abstract Background In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims to provide evidence that can be used to improve the medical insurance system. Methods Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The method of calculating the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME) was adopted from the World Health Organization (WHO). The treatment effect model was used to identify the determinants of CHE for rural middle-aged and elderly people. Results The incidence of CHE in rural China for middle-aged and elderly people is 21.8%, and the IME is 8.0%. The households that had enrolled in the NRCMS suffered higher CHE (21.9%) and IME (8.0%), than those that had not enrolled (CHE: 20.6% and IME: 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with three or more chronic diseases, inpatients, or households with members aged over 65 years. Key risk factors for the CHE included education levels, households with inpatients, households with members aged over 65 years, and households with disabilities. Conclusions Although the NRCMS has reduced barriers to the usage of household health services by reducing people’s out-of-pocket payments, it has not effectively reduced the risk of these households falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and which puts them at a greater risk of falling into poverty due to health impoverishment.

scholarly journals Ten-Year Poverty Alleviation Effect of the Medical Insurance System on Families With Members Who Have a Non-communicable Disease: Evidence From Heilongjiang Province in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Qi Xia ◽  
Lichun Wu ◽  
Wanxin Tian ◽  
Wenqing Miao ◽  
Xiyu Zhang ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
Health Expenditure ◽  
Communicable Disease ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Vulnerable Groups ◽  
Weak Links ◽  
Heilongjiang Province ◽  
Healthcare Needs ◽  
Out Of Pocket Payments

Aims: Non-communicable diseases (NCD) drag the NCD patients' families to the abyss of poverty. Medical insurance due to weak control over medical expenses and low benefits levels, may have actually contributed to a higher burden of out-of-pocket payments. By making a multi-dimensional calculation on catastrophic health expenditure (CHE) in Heilongjiang Province over 10 years, it is significant to find the weak links in the implementation of medical insurance to achieve poverty alleviation.Methods: A logistic regression was undertaken to predict the determinants of catastrophic health expenditure.Results: The average CHE of households dropped from 18.9% in 2003 to 14.9% in 2013. 33.2% of the households with three or more NCD members suffered CHE in 2013, which was 7.2 times higher than the households without it (4.6%). The uninsured households with cardiovascular disease had CHE of 12.0%, which were nearly 10% points lower than insured households (20.4–22.4%). For Medical Insurance for Urban Employees Scheme enrolled households, the increasing number of NCD members raised the risk of impoverishment from 3.4 to 20.0% in 2003, and from 0.3 to 3.1% in 2008. Households with hospital in-patient members were at higher risk of CHE (OR: 3.10–3.56).Conclusions: Healthcare needs and utilization are one of the most significant determinants of CHE. Households with NCD and in-patient members are most vulnerable groups of falling into a poverty trap. The targeting of the NCD groups, the poorest groups, uninsured groups need to be primary considerations in prioritizing services that are contained in medical insurance and poverty alleviation.

scholarly journals Does the medical insurance system really achieved the effect of poverty alleviation for the elderly in China? Characteristics of vulnerable groups and failure links

2019 ◽  
Author(s):  
Meiyan Ma ◽  
Ye Li ◽  
Nianshi Wang ◽  
Qunhong Wu ◽  
Linghan Shan ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
Household Head ◽  
Medical Insurance ◽  
The Elderly ◽  
Catastrophic Health Expenditure ◽  
Health Needs ◽  
Vulnerable Groups ◽  
Outcome Variable ◽  
Weak Links ◽  
Maximum Point

Abstract Objective: We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. Methods: A national representative sample from the 2015 China Health and Pension Tracking Survey (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. Results： The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. Conclusion： The original poverty -promoting policies has not reached the maximum point of convergence with China ‘s current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.

Participation in Adult Education by the Elderly: A Multivariate Analysis and Some Implications for the Future

1988 ◽  
Vol 7 (1) ◽  
pp. 4-16 ◽  
Author(s):  
Frank T. Denton ◽  
Peter C. Pineo ◽  
Byron G. Spencer
Keyword(s):  
Multivariate Analysis ◽  
Adult Education ◽  
Elderly Population ◽  
The Elderly ◽  
Probit Analysis ◽  
Micro Data ◽  
Quarter Century ◽  
Level Of Education ◽  
Education Levels ◽  
Average Education

ABSTRACTMicro-data from a 1984 survey of adult education in Canada are used in the study. The data for persons 65 years of age and over are analysed using probit techniques. Prior level of education is found to be of considerable importance in determining the probabilities that elderly people will make use of adult education facilities. It is argued that future elderly population cohorts will have higher average education levels than present ones and that their members will therefore be more likely to take courses. Projections of increases in course enrolment by persons 65 and over are made for the next quarter century, based on the results of the probit analysis and projections of the population.

scholarly journals Medical system and nutrition improvement for the rural elderly

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Zhenhua Wang ◽  
Jinqi Jiang ◽  
Qiyan Zeng
Keyword(s):  
Population Aging ◽  
Rural China ◽  
The Elderly ◽  
Rural Elderly ◽  
Medical System ◽  
Carbohydrate Intake ◽  
Nutrition Survey ◽  
Difference In Differences ◽  
Nutrition Intake ◽  
The Impact

Abstract Background Insufficient nutrition intake has negatively influenced the health of the elderly in rural China where the problem of population aging is serious. The present study aims to explore whether the medical system, called the New Rural Cooperative Medical System (NRCMS), can improve the rural elderly’s nutrition intake and the mechanism behind it. Methods The difference in differences (DID) model and the propensity score matching-difference in differences (PSM-DID) model are both performed to investigate the impact of the medical system on nutrition improvement for the rural elderly. Two thousand seven hundred eighty rural elderly samples tracked in 2000 and 2006 from the China Health and Nutrition Survey are analyzed. Indices for the elderly’s nutrition intake includes daily average intake of energy, fat, protein, and carbohydrate. Results The results show that participation in the NRCMS can significantly increase the rural elderly’s total energy intake, carbohydrate intake, and protein intake by 206.688 kcal, 36.379 g, and 6.979 g, respectively. A more significant impact of the NRCMS on nutrition intake is observed in the central and near-western where economic development is lagging behind. Also, compared to people of 18–60 age group, such impact is statistically more significant in the elderly for the carbohydrate intake. Conclusions The NRCMS can improve the rural elderly’s nutrition intake in China. As the population ages rapidly in rural China, the present study provides recommendations on how to improve nutrition and health status of the elderly from the aspect of the medical system.

scholarly journals Does Participation in Local Non-agricultural Employment Improve the Mental Health of Elderly Adults in Rural Areas? Evidence From China

2021 ◽  
Vol 9 ◽  
Author(s):  
Peng Jia ◽  
Jincai Zhuang ◽  
Andrea Maria Vaca Lucero ◽  
Charles Dwumfour Osei ◽  
Juan Li
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Rural China ◽  
The Elderly ◽  
Rural Elderly ◽  
Positive Contribution ◽  
Elderly Adults ◽  
Agricultural Employment ◽  
Employment Participation ◽  
Capital Development

A rising rate of suicide among the elderly in rural China has been recognized to be triggered by mental health-associated factors. This study uses 3,397 sampled rural elderly adults from China Labor-force Dynamic Survey in 2016 to explore the response mechanism through which non-agricultural employment participation by the elderly adults in rural China can influence their mental health. Utilizing the Multivariate Regression, Instrumental Variable and Propensity Score Matching methods, we find that, the rural elderly adults who participate in local non-agricultural employment significantly improve their mental health. Self-employment tends to have a greater positive contribution to the mental health of the elderly population than waged employment. Further, work income, need for belongingness and respect, and human capital development significantly mediates the influence of participation in local non-agricultural employment on the mental health of the elderly adults. Finally, we put forward relevant policy suggestions to improving the mental health of the elderly in the countryside.

scholarly journals Health-Related Quality of Life among Elderly Population of Bangladesh

2020 ◽  
Vol 15 (2) ◽  
pp. 161-164
Author(s):  
FM Shamim Ahmmed ◽  
Md Saydur Rahman ◽  
Farzana Zafreen ◽  
Rowshan Ara ◽  
Md Ziaul Islam
Keyword(s):  
Quality Of Life ◽  
Elderly Population ◽  
The Elderly ◽  
Significant Negative Correlation ◽  
Rural Elderly ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Introduction: Elderly population in Bangladesh is one of the largest in the world in term of absolute number and ageing is an emerging problem. Elderly are at risk from non-communicable diseases as well as mental problems and health-related quality of life (HRQoL) affects in urban and rural elderly. Objective: To find out and compare HRQoL in urban and rural elderly population of Bangladesh. Materials and Methods:A comparative cross-sectional study was carried out to compare HRQoL in urban and rural elderly. This was a two samples study; 130 each from urban and rural. Total 260 elderly were selected conveniently. Data were collected through face to face interview using a pre-tested semi structured questionnaire of SF-36 v2 HRQoL survey.  This study was carried in urban elderly residing in Ward number 3, Race Course, Cumilla City Corporation and in rural elderly residing in Noapuskuni Village of Babutipara Union, Muradnager Upazila, Cumilla. This one-year study was conducted from 15 July 2017 to 14 June 2018. Results: Majority of the elderly were Muslim (91.5%), female (53.5%), married (59.6%) and from joint family (91%). The mean ± SD age of elderly was 69.26±6.337 years and mean ± SD monthly family income was Tk. 16561.54±9192.076. SF- 36 v2 HRQoL scale; a licensed software-based survey tool was used measure the health-related quality of life of elderly.  Most of the elderly were found with average physical component summary (PCS) (53.1%) and mental component summary (MCS) (50.8%) of HRQoL. Age had significant negative correlation with PCS (p<0.001) and MCS (p<0.001) in urban and rural elderly. Education level of urban and rural elderly had significant positive correlation with PCS (p<0.01) and MCS (p<0.01). Marital status of urban and rural elderly had significant negative correlation with PCS (p<0.001) and MCS (p<0.001) of HRQoL. Among the rural respondents, the mean ± SD of PCS of male was 43.79±5.766 and female was 41.14±6.860. The difference was statistically significant (p<0.05). Mean score of PCS of urban and rural respondents were 45.68±6.366 and 42.43±6.467 respectively. This difference was statistically significant (p<0.001). Mean scores of MCS of urban and rural respondents were 43.96±4.921 and 42.56±7.028 respectively. This difference was not statistically significant (p>0.05). Conclusion: Most of the elderly had average level of health-related quality life. Rural female elderly had significantly lower physical health of HRQoL than that of rural male elderly. Physical dimension of HRQoL of rural elderly was significantly lower than that of urban elderly. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 161-164

scholarly journals Research on the Relationship between Widowhood, Social Participation and Life Satisfaction of Rural Elderly

2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Qing Dong ◽  
Xiaomin Li
Keyword(s):  
Life Satisfaction ◽  
Elderly People ◽  
Social Participation ◽  
Rural China ◽  
The Elderly ◽  
Rural Elderly ◽  
Shaanxi Province ◽  
Social Activities ◽  
Mediating Role ◽  
The Relationship

Objective: This study aims to explore the relationship between widowhood and social participation on life satisfaction of the elderly in rural China. Methods: We used questionnaires and scales to investigate 322 rural elderly people in Shaanxi Province. Results: We found that widowhood was negatively correlated with social participation (P = 0.033). Widowhood was negatively correlated with life satisfaction (P = 0.007). Social activities play a mediating role between widowhood and life satisfaction. Conclusion: Widowhood directly affects the life satisfaction of the elderly, and widowhood affects the life satisfaction of the elderly through social activities. More participation in social activities is an effective way to improve the life satisfaction of the elderly.

The new rural social pension program in rural China: participation and its correlates

2016 ◽  
Vol 8 (4) ◽  
pp. 647-661 ◽  
Author(s):  
Qiran Zhao ◽  
Stephan Brosig ◽  
Renfu Luo ◽  
Linxiu Zhang ◽  
Ai Yue ◽  
...  
Keyword(s):  
Labor Supply ◽  
Rural China ◽  
The Elderly ◽  
Rural Elderly ◽  
Pension Scheme ◽  
Data Set ◽  
Content Type ◽  
Pension Program ◽  
Social Pension ◽  
The Impact

Purpose The need for a universal rural pension system has been heightened by demographic changes in rural China, including the rapid aging of the nation’s rural population and a dramatic decline in fertility. In response to these changes, China’s Government introduced the New Rural Social Pension Program (NRSPP) in 2009, a voluntary and highly subsidized pension scheme. The purpose of this paper is to assess the participation of rural farmers in the NRSPP. Furthermore, the authors examine whether the NRSPP affects the labor supply of the elderly population in China. Design/methodology/approach This paper uses household-level data from a sample of 2,020 households originating from a survey conducted by the authors in five provinces, 25 counties, and 101 villages in rural China. Using a probit model and conducting correlation analysis, the authors demonstrate the factors affecting the participation and the impact of NRSPP on labor supply of the rural elderly. Findings The results show there are several factors that are correlated with participation, such as specific policy variant in force in the respective household's province, the size of the pension payout from government, the age of sample individuals, and the value of household durable assets. Specifically, different characteristics of NRSPP policy implementation increase participation in China’s social pension program. The results suggest that the introduction of the NRSPP has not affected the labor supply of the rural elderly, in general, although it has reduced participation for the elderly who were in poor health. Originality/value Several previous studies have covered the NRSPP. However, all previous studies were based on case studies or just focused on a small region, and for this reason the results cannot reflect the populations and heterogeneity of rural areas. Therefore, a data set with a large sample size is used in this paper to provide a new perspective to fully understand the participation of NRSPP and its impacts on rural households. This paper will make an update contribution to the literature in the area of pension programs in China.

scholarly journals Catastrophic health expenditure: A comparative study between hypertensive patients with and without complication in rural Shandong, China

2020 ◽  
Author(s):  
Xinyi Zhang ◽  
Qiongqiong Xu ◽  
Xiaolei Guo ◽  
Zhengyue Jing ◽  
Long Sun ◽  
...  
Keyword(s):  
Living Arrangements ◽  
Health Expenditure ◽  
Rural China ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Inpatient Service ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Out Of Pocket Payments

Abstract Background: Some previous studies have assessed catastrophic health expenditure (CHE) in households with hypertensive patients, but few have examined the difference of CHE in hypertensive patients with and without complications. The purpose of this study is to compare the incidence and determinants of CHE between hypertensive patients with and without complications. Methods: Data of this study were from a cross-sectional study in Shandong Province in China in 2016. Of the recruited 3,457 hypertensive patients registered in the NCDs management system in the sampling villages, 3,113 completed the survey, with a response rate of 90.05%.CHE was defined as out-of-pocket payments for hypertensive care that equaled or exceeded 40% of the household capacity to pay (non-food expenditure). Hypertension complications (e.g., stroke, coronary heart disease, hypertensive kidney disease, etc.) were collected in this study, which was categorized into 0 (no), 1(single), and 2 and more according to the types of hypertensive complications. We employed Chi-square test to explore associated factors and logistic regression model to identify the determinants of CHE. Results: The incidence of CHE and impoverishment is 13.6% and 10.8% among hypertensive patients. The incidence of CHE with one complication is 25.3% ( R =0.000, OR=2.29 ) and 47.3% ( P =0.000, OR=3.60 ) in patients with two or more complications, which are both statistically higher than that in patients without complication (6.1%). Across all types of patients, income levels are inversely related to the incidence of CHE. Patients who use outpatient or inpatient service are more likely to experience CHE ( R =0.000 ). Factors including living arrangements, family size, educational attainment are found to be significantly associated with CHE in some subgroups ( P ＜ 0.05 ). Conclusions: CHE and impoverishment incidence among hypertensive patients are both high in rural China. Patients with hypertensive complication are at higher catastrophic risk than those without complication.More attention needs to be paid to households with hypertension patients, especially for those with hypertension complications.

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