Association between social determinants of health and direct economic burden on middle-aged and elderly individuals living with diabetes in China

The aim of this study was to determine the association between social determinants of health and direct economic burden on Chinese middle-aged and elderly individuals living with diabetes in China. This study used data from the baseline wave of The China Health and Retirement Longitudinal Study (CHA...

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Bibliographic Details
Published in:PloS one Vol. 16; no. 4; p. e0250200
Main Authors: Guo, Jianwei, Wu, Yun, Deng, Xinlei, Liu, Zifeng, Chen, Lijin, Huang, Yixiang
Format: Journal Article
Language:English
Published: United States Public Library of Science 15.04.2021
Public Library of Science (PLoS)
Subjects:
Aged
Aging
Cardiovascular diseases
Complications
Computer programs
Costs
Data analysis
Data centers
Demographic aspects
Diabetes
Diabetes in old age
Diabetes mellitus
Drafting software
Economic aspects
Economic impact
Economics
Editing
Environmental health
Expenditures
GDP
Geriatrics
Gross Domestic Product
Health aspects
Health policy
Health services
Households
Longitudinal studies
Medicine and Health Sciences
Mental disorders
Methodology
Middle age
Older people
People and Places
Population
Poverty
Public health
Reviews
Social aspects
Social determinants of health
Social Sciences
Software
China
United States > US
ISSN:1932-6203, 1932-6203
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Summary:The aim of this study was to determine the association between social determinants of health and direct economic burden on Chinese middle-aged and elderly individuals living with diabetes in China. This study used data from the baseline wave of The China Health and Retirement Longitudinal Study (CHARLS) database, covering 17,708 middle-aged and elderly residents in China. The population with diabetes was grouped into those diagnosed with diabetes mellitus (DDM) and those undiagnosed with diabetes mellitus (UDM). Direct economic cost data, including total direct medical costs (TC) and out-of-pocket (OOP) payments, were extracted as outcome variables. A two-part model was applied to analyze the association between social determinants of health and direct economic burden. In our analysis, we included 958 patients with DDM and 1,285 patients with UDM. The mean TC and OOP payments were 11,193 CNY (US $1,733; 6.46 CNY = 1 USD) and 7,266 CNY (US $1,125) in DDM patients, and 3,700 CNY (US $573) and 3,060 CNY (US $474) in UDM patients. Rural-urban status (p<0.05), regional status (p<0.05), household personal consumption expenditures (p<0.05), and comorbidities(p<0.05) were crucial factors associated with medical costs in people with diabetes. Although progress has been made in the development of current health policies intended to contain the direct economic burden of diabetes, the gaps in that burden in populations with different social characteristics remains a burning issue. More policy breakthroughs are needed to achieve health equity.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0250200