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Financial burden of older inpatients with multimorbidity in China

A cross-sectional study

Bibliographic Data

ID22083198
AuthorsBensong Xian (Mahidol University), Seung Chun Paek (0000-0002-9483-5572, Inner Mongolia Medical University), Weiyun Jin (0000-0001-6735-2404, Mahidol University), Thammarat Marohabutr (0000-0003-1471-0276, Mahidol University)
Year2026
Volume14
Pages1767499-1767499
Publication date2026-04-30
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1767499
PMID42145475
OpenAlexW7159802152
LanguageEN
References cited40

Background: In China, which has the world's largest and one of the fastest-aging populations, multimorbidity has become a major public health challenge. Older individuals with multiple chronic conditions experience poor health outcomes, increased healthcare utilization, and substantial financial pressure. This study investigates of the financial burden on older inpatients with multimorbidity. Methods: -test, ANOVA), and multiple linear regression to identify key drivers of medical costs and out-of-pocket expenses for older inpatients with multimorbidity. Results: The study revealed a high multimorbidity rate of 73.8% among 106,202 inpatients aged ≥50 years from six Chinese hospitals in 2022. The average total hospitalization cost was 10,318 yuan, with an out of pocket expense (OOPE) of 4,558 yuan. Descriptive analysis showed the largest patient proportion was aged 60-69 years (38.4%) and most had 2-4 chronic conditions. Analysis of medical expenses identified significant variations. Patients with urban employee insurance had higher total costs but lower OOPE (24.99% proportion) compared to those with urban-rural resident insurance (50.89% proportion). Treatment in tertiary hospitals and longer hospital stays were strongly associated with higher costs. Multiple regression confirmed hospital level, length of stay, and surgical intervention were the most significant positive predictors of total costs. For OOPE, health insurance type, hospital level, and length of stay were major influencing factors. Conclusion: Multimorbidity is highly prevalent and imposes a substantial financial burden on older inpatients. Strengthening prevention, optimizing insurance design, and improving integrated care are essential for promoting healthcare equity and sustainability in China

Descriptive statistics · Health care · Health economics · Health insurance · Interquartile range · Logistic regression · Medical insurance · Multimorbidity · Public health · Public hospital · Chronic Disease Management Strategies · Healthcare Policy and Management · Healthcare Systems and Reforms

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