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Table 5 Factors associated with the incidence of catastrophic health expenditure at various thresholdsa

From: Catastrophic health expenditure and its association with socioeconomic status in China: evidence from the 2011-2018 China Health and Retirement Longitudinal Study

Characteristics

Fixed threshold (40%)

Variable thresholds

Q1 = 40%b

Q3 = 40%c

Q5 = 40%d

OR (95% CI)

P-value

OR (95% CI)

P-value

OR (95% CI)

P-value

OR (95% CI)

P-value

Survey years

 2011

 2013

0.975 (0.851-1.118)

0.720

1.049 (0.889-1.237)

0.574

1.119 (0.979-1.280)

0.099

2.039 (1.844-2.254)

<0.0001

 2015

0.971 (0.864-1.092)

0.622

1.093 (0.948-1.260)

0.220

1.141 (1.014-1.283)

0.028

1.670 (1.524-1.830)

<0.0001

 2018

2.121 (1.881-2.391)

<0.0001

3.203 (2.776-3.695)

<0.0001

2.229 (1.969-2.523)

<0.0001

1.323 (1.196-1.464)

<0.0001

Per-capita household expenditure quintilese

 Q5

 Q4

3.284 (2.728-3.954)

<0.0001

4.914 (3.586-6.732)

<0.0001

6.014 (4.416-8.191)

<0.0001

9.159 (7.706-10.886)

<0.0001

 Q3

6.129 (5.115-7.344)

<0.0001

10.834 (7.993-14.684)

<0.0001

24.088 (17.907-32.402)

<0.0001

37.946 (31.878-45.170)

<0.0001

 Q2

9.284 (7.748-11.125)

<0.0001

24.607 (18.219-33.236)

<0.0001

47.824 (35.537-64.358)

<0.0001

57.029 (47.739-68.127)

<0.0001

 Q1

18.203 (15.131-21.900)

<0.0001

73.990 (54.523-100.408)

<0.0001

119.603 (88.411-161.798)

<0.0001

86.717 (72.179-104.182)

<0.0001

Education

 Illiterate

 Primary school and below

1.158 (1.028-1.304)

0.016

1.141 (1.002-1.300)

0.047

1.123 (0.998-1.264)

0.053

1.125 (1.014-1.247)

0.026

 Secondary school

1.173 (1.015-1.357)

0.031

1.162 (0.989-1.365)

0.068

1.127 (0.975-1.303)

0.106

1.111 (0.980-1.259)

0.099

 College school and above

0.948 (0.597-1.505)

0.820

0.927 (0.502-1.711)

0.808

1.015 (0.607-1.697)

0.954

1.326 (0.920-1.911)

0.130

Health insurance

 No insurance

 UEBMIf

1.332 (0.922-1.923)

0.127

1.178 (0.776-1.790)

0.442

1.381 (0.954-1.999)

0.088

1.520 (1.133-2.038)

0.005

 UBMIg

1.291 (0.964-1.728)

0.086

1.221 (0.888-1.679)

0.218

1.437 (1.082-1.909)

0.012

1.505 (1.200-1.888)

<0.0001

 Othersh

1.139 (0.780-1.664)

0.501

1.098 (0.716-1.684)

0.667

1.213 (0.827-1.779)

0.323

1.385 (1.022-1.876)

0.036

Disease status

 No morbidity

 Single morbidity

1.432 (1.238-1.657)

<0.0001

1.380 (1.163-1.636)

<0.0001

1.598 (1.383-1.846)

<0.0001

1.415 (1.272-1.574)

<0.0001

 Multimorbidity

2.191 (1.918-2.503)

<0.0001

2.150 (1.844-2.507)

<0.0001

2.446 (2.142-2.794)

<0.0001

2.382 (2.153-2.634)

<0.0001

Type of healthcare utilization

 Neither outpatient nor inpatient service use

 Outpatient service use

3.141 (2.830-3.485)

<0.0001

3.042 (2.695-3.435)

<0.0001

3.112 (2.797-3.463)

<0.0001

2.656 (2.421-2.913)

<0.0001

 Inpatient service use

2.521 (2.208-2.879)

<0.0001

2.511 (2.156-2.926)

<0.0001

2.520 (2.191-2.899)

<0.0001

1.999 (1.766-2.264)

<0.0001

 Both outpatient and inpatient service use

5.508 (4.626-6.558)

<0.0001

5.746 (4.710-7.010)

<0.0001

5.562 (4.608-6.714)

<0.0001

4.225 (3.529-5.058)

<0.0001

Age (years)

1.017 (1.011-1.022)

<0.0001

1.015 (1.008-1.021)

<0.0001

1.016 (1.010-1.021)

<0.0001

1.012 (1.007-1.017)

<0.0001

Sex

 Male

 Female

1.098 (0.998-1.208)

0.054

1.133 (1.018-1.262)

0.022

1.115 (1.013-1.227)

0.027

1.089 (1.003-1.181)

0.042

Rurality of residence

 Urban areas

 Urban-rural areas

1.059 (0.831-1.349)

0.644

1.181 (0.886-1.574)

0.257

1.144 (0.888-1.476)

0.298

0.919 (0.748-1.128)

0.418

 Rural areas

0.980 (0.780-1.232)

0.865

1.015 (0.775-1.330)

0.912

0.983 (0.775-1.248)

0.890

0.931 (0.767-1.129)

0.466

Marital status

 Living alonei

 Married or partnered

2.717 (2.405-3.069)

<0.0001

2.504 (2.192-2.861)

<0.0001

2.787 (2.470-3.145)

<0.0001

3.026 (2.734-3.350)

<0.0001

Ethnicity

 Han

 Other ethnic groups

1.237 (1.025-1.491)

0.026

1.168 (0.952-1.435)

0.137

1.165 (0.961-1.412)

0.121

1.107 (0.928-1.321)

0.258

Household size

0.840 (0.809-0.872)

<0.0001

0.848 (0.811-0.887)

<0.0001

0.871 (0.840-0.903)

<0.0001

0.907 (0.883-0.932)

<0.0001

Variance components

Variance

Standard deviation

Variance

Standard deviation

Variance

Standard deviation

Variance

Standard deviation

 Household

0.540

0.066

0.459

0.081

0.490

0.066

0.625

0.052

 Community

0.181

0.028

0.137

0.028

0.192

0.029

0.264

0.030

Akaike Information Criterion (AIC)

18934.92

14292.06

18135.98

27199.96

Bayesian Information Criterion (BIC)

19165.45

14522.59

18366.51

27430.49

  1. aOdds ratios (OR), 95% confidence intervals (CI), and p-value significantly related to catastrophic health expenditure are bolded
  2. bQ1 = 40% means that 40% was selected as the threshold level for Q1, and the thresholds for other quintiles were estimated by multiplying 40% by the ratio of average food expenditure in certain quintile to that in Q1
  3. cQ3 = 40% means that 40% was selected as the threshold level for Q3, and the thresholds for other quintiles were estimated by multiplying 40% by the ratio of average food expenditure in certain quintile to that in Q3
  4. dQ5 = 40% means that 40% was selected as the threshold level for Q5, and the thresholds for other quintiles were estimated by multiplying 40% by the ratio of average food expenditure in certain quintile to that in Q5
  5. eQuintile 1 is the poorest and Quintile 5 is the wealthiest
  6. fUEBMI Urban Employee Basic Medical Insurance
  7. gUBMI Unified Basic Medical Insurance
  8. hOthers = Government medical insurance, Medical aid, Private medical insurance: purchased by work unit, Private medical insurance: purchased by individual, urban non-employed person’s health insurance, Long-term care insurance, and Other medical insurance
  9. iLiving alone means separated, divorced, widowed, or unmarried
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International Journal for Equity in Health

ISSN: 1475-9276

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