ABSTRACT
Older adults’ access to healthcare services may have been affected by the COVID-19 pandemic. This study explored the effect of the first wave pandemic on the medical expenditure of older adults in China. Difference-in-Difference models captured both temporal and geographical variation in COVID-19 exposure to estimate the impacts of the pandemic on medical expenditure through a quasi-natural experiment. Data derived from the China Family Panel Studies. Results indicate that exposure to the pandemic significantly decreased total medical expenditures, hospital expenditures, and non-hospital medical expenditures of Chinese older adults by 15% (95% CI 12%–17%), 5% (95% CI 2%–7%), and 15% (95% CI 13%–16%), respectively, for each standardized severity increment. Females, less well-educated people, and individuals without internet access were most susceptible to experiencing these reductions. This study revealed that COVID-19 exerted a detrimental influence on the medical expenditure of older adults in mainland China. The “hidden epidemic” of non-COVID-19 medical needs of older adults deserves more attention on the part of policymakers.
Key Points
Medical expenditure declined markedly among older adults after exposure to the first-wave pandemic.
The decline in medical expenditure was more notable among females, individuals with lower educational attainment, and those without internet access.
We need to reconsider the important public health issues about how to ensure the supply of medical services in addition to COVID-19, how to meet the medical needs of the older adults facing different dilemmas, and how to address the needs of the even vulnerable group of the older adults.
Abbreviations
TE | = | Total Expenditure |
HE | = | Hospitalization Expenditure |
NE | = | Non-hospitalization Expenditure |
Acknowledgments
The authors thank all the interviewees, researchers, and related staff in the CFPS. We also thank the support of Peking University for initiating the authors’ research. Special thanks are extended to the three anonymous reviewers for their valuable suggestions.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author contributions
Concept and design: Chao Guo, Xiyuan Hu. Analysis and interpretation of data: Xiyuan Hu, Dianqi Yuan, and Chao Guo. Writing-original draft: Xiyuan Hu. Writing-review and editing: Xiyuan Hu, Dianqi Yuan, Yuyu Zeng, and Chao Guo.
Data availability statement
Data are available upon reasonable request. This study is based on publicly available datasets, and the original data can be accessed after registration and application from the website: http://www.isss.pku.edu.cn/cfps/en/data/public/index.htm.
Ethics approval
The survey was reviewed and approved by the Peking University Biomedical Ethics Review Committee (Approval number: IRB00001052–14010).
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/08959420.2024.2348967
Correction Statement
This article has been corrected with minor changes. These changes do not impact the academic content of the article.