Objective To explore demand and utilization of medical service among home-dwelling elderly with disability in China and to provide evidences for the establishment of long-term care system.
Methods We extracted the data on home-dwelling elderly from three waves of China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011,2013 and 2015. The disability conditions of the elderly were assessed with the Activity of Daily Living Scale (ADL) and then demand and utilization of medical service among the elderly with various disability condition were described and compared.
Results The disability rate was 10.09%, 9.62%, and 10.14% among the 7 541, 8 751, and 9 326 elderly surveyed in 2011, 2013, and 2015, respectively, and there was no significant yearly difference in the rate (P > 0.05). For the elderly identified with disabilities in the three waves of the survey, the self-reported disease prevalence rate was 41.92%, 45.13%, and 42.92% and the rate of outpatient clinic visit was 28.91%, 30.76%, and 27.18% during previous one month till the surveys, without yearly variation (P > 0.05); whereas the proportion of the elderly wanting but not having the outpatient visit was 15.37%, 17.45%, 20.19% among the elderly disabled, with an significantly increasing trend (χ2trend = 6.759, P = 0.009). In the three waves of the surveys among the elderly with disability, the proportion of requiring hospitalization was 29.43%, 35.99%, and 39.96% and the reported hospitalization rate was 22.21%, 29.45%, and 32.91% during previous one year till the surveys and there was a significant increasing trend for the proportion and the rate (both P < 0.001); while the proportion of the elderly wanting but not having the hospitalization was 9.59%, 10.93%, and 11.83%, without significant variation (P > 0.05).
Conclusion Both the demand and the utilization of inpatient medical service increased but the utilization of outpatient service decreased from 2011 to 2015 among the home-dwelling elderly with disability in China.
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