Healthcare costs attributable to noncommunicable diseases: a longitudinal study based on the elderly population in China

Abstract

Abstract BackgroundThe burden of disease and economic losses caused by aging populations and non-communicable chronic diseases (NCD) are significant public health concerns. Estimates of healthcare costs attributed to chronic diseases in the senior population can inform the creation of disease preventive and control policies. This study therefore utilized an econometric method to estimate the chronic disease attributable fraction (CDAF) of yearly per capita healthcare costs in older persons, which includes all potential costs.MethodsThis study employed the three waves of panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The data evaluate the annual per capita utilization and cost of outpatient and inpatient healthcare for the elderly. A two-part model was utilized to estimate outpatient, inpatient, and healthcare costs associated to the six selected chronic conditions.ResultsThe top six chronic diseases of the surviving elderly in China are hypertension, arthritis, heart disease, cataract, chronic lung disease, stroke or cardiovascular disease (CVD). The CDAF for outpatient costs, inpatient costs, and healthcare costs were 44.99%, 64.73%, and 55.18%, respectively. Among them, the CDAFs of hypertension in outpatient costs and total healthcare costs were 12.53% and 12.50%; the CDAF of arthritis in outpatient costs was 5.95%; the CDAFs of heart disease in outpatient costs, hospitalization costs and healthcare costs were 17.85 %, 33.84%, and 24.49% respectively; the CDAFs of cataract in outpatient costs and healthcare costs were 4.60% and 5.67%; the CDAFs of chronic lung disease in outpatient costs, inpatient costs, and healthcare costs were 7.50%, 17.03%, and 11.96%; CDAFs of stroke or CVD in outpatient cost, inpatient cost, and healthcare cost were 7.96%, 23.54%, and 16.94%. In addition, gender, place of residence, and degree of education affect the cost attribute to chronic disease in older persons.ConclusionIn the healthcare service cost of the elderly, the attributed cost of chronic diseases has significant differences, mainly reflected in the elderly's gender, living environment, and preference for outpatient or inpatient treatment. Based on this, the prevention and treatment policies formulated for specific chronic diseases can help reduce the health and economic burden of the society.