Healthcare underutilization in middle-aged and elderly adults in China

Objectives: This article investigates the prevalence of, illness conditions associated with, and reasons for healthcare underutilization among middle-aged and elderly adults in China. It also identifies participants characteristics associated with healthcare underutilization. Study design: A cross-sectional survey was conducted in Beijing and Henan in August 2016. Methods: The survey was questionnaire-based. It focused on middle-aged and elderly persons aged 45 years and older. A total of 1778 people were surveyed. Results: In the end, 243 participants (30.11%) and 312 participants (32.13%) displayed signs of healthcare underutilization in Beijing and Henan, respectively. The disease conditions and reasons for underutilization were different in these two areas. Age group, marital status, education level, occupation, and chronic disease were found to be associated with healthcare underutilization in Beijing, whereas gender, age group, marital status, education level, and chronic disease were associated with healthcare underutilization in Henan. Conclusions: Illness conditions, reasons for underutilization, and risk factors associated with healthcare underutilization were different in developed areas compared with developing areas of China. Further reforms and interventions are needed to consider these problems. (C) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.