Patterns of Expenditure in Healthcare for Elderly in Shanghai

Abstract

This study aims to summarise the characteristics of elderly care system and analyse expenditures of healthcare for the elderly in Shanghai. The authors use medical records of 2015 and health account results of 2014 based on System of Health Accounts 2011 to describe the pattern of care expenditures for elderly. Individuals aged 60 years and above account for 19.5 per cent of Shanghai’s population but utilise 52.2 per cent of all outpatient visits and 45.3 per cent of all hospitalisations. Almost two-thirds of their medical expenditures occur in hospitals and 16 per cent in community health centres, corresponding to the status of resource allocation. The out-of-pocket payment ratio of the elderly is lower than that of the younger adults, which is attributable to the preferential reimbursement polices set by the insurance schemes. The leading causes of expenditures are cardiovascular disease, neoplasms and respiratory diseases. Care for the elderly costs more, and the elderly use more services than other age groups. The article recommends the monitoring of irrational utilisation of services, strengthening of primary level care and integration of services across different facilities to streamline care for elderly in Shanghai.