Navigating healthcare for older adults after a chronic illness diagnosis: Evidence from China

Abstract

Chronic illnesses require lifelong medical treatment and significantly impact healthcare utilization. Newly diagnosed individuals often face challenges in navigating decisions between inpatient care, outpatient care, and self-care. This study examines the effects of chronic illness diagnosis on healthcare utilization among middle-aged and older adults using nationally representative longitudinal data from China. Using an event study approach, we find that a diagnosis leads to significant increases in inpatient and outpatient service use, as well as self-medication. Over time, reliance on inpatient care and self-medication intensifies. Healthcare access and affordability play a critical role, with individuals in low cost-sharing programs experiencing higher expenditures. Supplemental insurance plans are associated with lower inpatient service use, while cashless payment settlement is linked to higher inpatient utilization. Better access to primary healthcare reduces inpatient service use and overall healthcare expenditures, underscoring the gatekeeping role of primary care.