Journal of Public Health Advance Access published online on February 6, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp007
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Perceived unmet need for hospitalization service among elderly Chinese people in Zhejiang province
Wang Junfang, Postdoctoral Fellow, Lecturer in Epidemiology and Biostatistics
Zhou Biao, Associated Professor of Epidemiology and Biostatistics
Zheng Weijun, PhD Candidate
Shuangshuang Zhang, PhD Candidate
Wu Yinyin, PhD Candidate
Kun Chen, Professor of Epidemiology and Biostatistics
Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, China
Address correspondence to Kun Chen, E-mail: CK{at}zju.edu.cn
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Abstract |
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Background In this study, we determined the prevalence of unmet need for hospitalization service and the characteristics of the elderly with this unmet need in Zhejiang province, China.
Methods Data were collected from a random sample of 4046 Chinese aged 60 years and older in Zhejiang province. Based on the Andersen-Newman service utilization framework, multivariable logistic regression analysis was used to determine independent effects of these variables on the likelihood of having an unmet need for hospitalization service.
Results Overall, the prevalence of unmet need was 16.2% for hospitalization service. Among predisposing factors, only educational level was statistically significant. Individuals with higher education were less likely to report unmet needs. Among enabling factors, residential area, social support, personal yearly income and personal healthcare expenditure were strongly associated with the presence of unmet need. Those with less enabling resources (e.g. residing in rural areas) were more likely to report unmet need [Odds ratio (OR) = 1.5–6.5]. All the need factors, except for physical function, were strongly associated with the presence of unmet need. Seniors in poorer health (e.g. in fair or poor health) were more likely to report unmet need than their counterparts in better health (OR = 1.5–2.8).
Conclusions In spite of relatively high insurance coverage rates, unmet need for hospitalization service remains high among the elderly people of Zhejiang province in China. Application of comprehensive intervention strategies such as conducting health education, creating social support, promoting community participation and promoting inter-sectional cooperation may be more effective in reducing unmet need for hospitalization service.
Keywords: aging, Chinese, elderly, hospitalization, unmet need