Can Medical Insurance Coverage Reduce Health Disparities in Long-term Care Elderly: A Case From China

INTRODUCTION: China’s population is aging rapidly partly because of the impact of one-child policy and the improvement of health care system. Caring for bedridden seniors can be a challenge for many families in China. The aim of this study was to identify the inequality of income among different age groups and social status, and evaluate the medical burden and insurance compensation in Zhejiang Province in China.

METHODS: We measured income inequality and compensation level of insurance among bedridden patients in urban and rural areas of Zhejiang province, China. Factor analysis and Gini coefficient were used to evaluate degree of income inequality and insurance compensation level.

RESULTS: We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses and length of time being bed-ridden. The income Gini coefficient of long-term care individuals in urban and rural areas was 0.335 and 0.602, respectively. In all age groups, the Gini coefficient increased after paying for the medical expenditure, and the inequality still existed after insurance reimbursement.

CONCLUSIONS: Significant income disparities were observed between rural and urban areas of Zhejiang Province. Inequality increased along with age growth. The medical expenditure is a huge burden for long term care elderly, especially for senior citizens. The medical insurance does not play a significant role in reducing the inequalities among long-term care people.