Chronic diseases and catastrophic health expenditures in elderly Chinese households: a cohort study

作者：Xueying Yao, Dandan Wang, Tiantian Zhang, Qian Wang · 发表于：BMC Geriatrics · 年份：2025 · 被引用次数：18 · 研究领域：Healthcare Systems and Reforms、Global Health Care Issues、Health disparities and outcomes

BACKGROUND: Catastrophic health expenditure (CHE) is a key indicator for studying the economic burden of diseases. Previous study mainly focused on exploring the relationship between severe diseases such as cancer and multimorbidity with CHE. However, there is a lack of research exploring the differential effects of single and multiple chronic diseases on CHE. This study aims to analyse the longitudinal association between different chronic disease conditions and CHE among elderly households in China, and investigate whether this association is influenced by other demographic and socioeconomic variables. METHODS: A total of 6,483 older adults obtained from four waves (2013, 2015, 2018, 2020) of the China Health and Retirement Longitudinal Study (CHARLS) were analysed (elderly household without CHE at baseline were included). CHE was defined as out-of-pocket health expenditures exceeding 40% of household non-food expenditures. Mixed-effects logistic regression models were employed to explore the longitudinal relationship between different chronic diseases conditions and CHE, and stratification analyses were conducted to explore the potential moderation effect. RESULT: The analysis indicates that both single chronic diseases(P < 0.001) and multimorbidity(P < 0.001) significantly increase the risk of CHE in elderly households. A stratified analysis based on population and socio-economic variables showed similar results. Besides, when the threshold for CHE was set at 40% of house...