Income inequality and healthcare utilization of the older adults-based on a study in three provinces and six cities in China

Dados Bibliográficos

ID22073184
AutoresZhang Chi (0000-0003-1431-7722), Chi Zhang (0000-0003-0034-843X, Lanzhou University, autor correspondente), Hai Lun (Xi'an Jiaotong University), Jiaxin Ma (0000-0003-4479-0991, Lanzhou University), Yaping Zhou (0000-0002-7812-851X, Lanzhou University, autor correspondente)
Ano2024
Volume12
Páginas1435162-1435162
Data de publicação2024-07-24
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoFrontiers in Public Health (JOURNAL)
Identificadores do periódicoISSN: 2296-2565 • E-ISSN: 2296-2565
EditoraFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1435162
PMID39114522
OpenAlexW4400963297
IdiomaEN
Citações recebidas5
Referências citadas57

Purpose The objective of this study is to gain a more nuanced understanding of the specific impact of income inequality on the utilization of healthcare services for older adults. Additionally, the study aims to elucidate the moderating and mediating roles of public transfer income and psychological health in this context. Methods A systematic examination of the impact of income inequality on healthcare utilization among older adults was conducted through field questionnaire surveys in six cities across three major geographical regions (West, Central, and East). The analysis employed baseline regression, as well as mediating and moderating effect tests. Results First, there is a negative relationship between income inequality and the use of therapeutic healthcare services (β 1 = −0.484, P < 0.01) and preventive healthcare services (β 2 = −0.576, P < 0.01) by older adults. This relationship is more pronounced in the low- and medium-income groups as well as in the western region. The mediating effect of psychological state is significant (β 3 = −0.331, P < 0.05, β 4 = −0.331, P < 0.05). Public transfer income plays a significant role in regulation. The moderating effect of public transfer income on therapeutic services was more significant in low-income groups (β 5 = 0.821, P < 0.01). The moderating effect of public transfer income on preventive services was more significant in middle-income groups (β 6 = 0.833, P < 0.01). Conclusion The study clearly demonstrates a significant negative correlation between income inequality and the utilization of healthcare services by older adults. Furthermore, the study reveals that this relationship is particularly pronounced among older adults in low- and medium-income and Western regions. This detailed analysis of regional and income level heterogeneity is of particular value in this field of research. Secondly, this study attempts to integrate the two pivotal dimensions of public transfer income and psychological state for the first time, elucidating their moderating and mediating roles in this relationship. The findings indicate that public transfer income serves as a moderating factor, exerting a notable “reordering effect” on income inequality and resulting in a “deprivation effect.” Such factors may impede the utilization of medical services, potentially influencing the psychological state of older adults

China · Demographic economics · Economic growth · Economic inequality · Economics · Environmental health · Geography · Health care · Household income · Inequality · Moderation · Public health · Socioeconomics · Sociology · Demography · Health disparities and outcomes · Healthcare Systems and Reforms · Intergenerational Family Dynamics and Caregiving · Medicine · Nursing · Psychology · Social Psychology