Measurement and determinants of catastrophic health expenditure among elderly households in China using longitudinal data from the CHARLS

Abstract Background Catastrophic health expenditure (CHE) among the Chinese elderly warrants attention. However, incidence, intensity and determinants of CHE have not been fully investigated. This study explores citizens, i.e., those aged 60 years or older. Methods Data were obtained from three waves China Health Retirement Longitudinal Study (CHARLS): 2011, 2013 2015. The cut-off points used in this for 10% total expenditures 40% non-food expenditure. Under guidance Andersen’s model services utilization, logistic regression analysis to explore CHE. Results incidence defined as more than rose over period, 2011–2015, 20.86% (95% CI: 19.35 22.37%) 31.00% 29.28 32.72%). also increased. overshoot (O) based on 3.12% 2.71 3.53%) 8.75% 8.14 9.36%), while mean positive (MPO) 14.96% 12.99 16.92%) 28.23% 26.26 30.19%). Thus, problem CEH was even serious 2015 2011. Logistic revealed that households likely face if they had a spouse household member, reported an inpatient event last year, outpatient visit month, disabled, members poor quartile, lived middle western zones resided urban area. In contrast, significantly affected by respondents being older 75 having chronic condition, size insurance type. Conclusions Key policy recommendations include gradual improvement medical assistance expansion use reduce liability expenditures.