The Influence Of Family Care On The Utilization Of Medical Services For The Elderly In China

With the rapid development of the economy,the proportion of the elderly aged 60 and above in the total population has been increasing in China.By the end of 2018,the number of the elderly aged 60 and above in China had reached 249.49 million,accounting for 17.9%of the total population.The medical expenditure of the elderly increases year by year,bringing heavy economic pressure to individuals,families and society.And the increase of the elderly also brings care needs to families,increasing the burden of social pension.At present,the aging trend of China’s population is more and more obvious and the problem of old-age care is more and more serious,so it is of great practical significance to pay attention to the influence of family care on the utilization of medical services for the elderly.This paper reviews the following literature,including the influence mechanism of family care on the utilization of medical services for the elderly,the endogeneity of family care in the utilization of medical services for the elderly,the impact of family care on the likelihood and the amount of elderly people using medical services.The paper also summarizes and reviews the existing related literature.Based on the health needs theory which introducing family care and Andersen’s behavioral model of health service utilization,this paper uses the national baseline data of China Health and Retirement Longitudinal Survey for 2015,making the number of surviving daughters in offspring as instrumental variable,selecting many explained variables.This article analyzes the influence of family care on the utilization of medical services for the elderly in our country through Ⅳ-Probit model and Ⅳ-Tobit model for purpose of the robust conclusions.Firstly,this paper uses the Ⅳ-Probit model to analyze the impact of family care on the elderly’s access to medical services.Then it measures the use of medical services by medical expenditure and hospital stays,and uses the Ⅳ-Tobit model to analyze the relationship between family care and medical expenditure and hospital stays for the elderly in China.Finally,this paper further analyzes the heterogeneity of different age groups and groups with or without chronic diseases.After controlling the endogeneity of family care variables through instrumental variables,it is found that family care has significant complementary effects on the elderly’s use of medical services.The empirical study mainly draws the following conclusions:(1)Family care can significantly increase the probability of elderly people using medical services.The longer the family care is,the more medical expenses will be.For hospitalization,the longer the family care is,the longer the hospitalization time will be.(2)Family care has a complementary effect on the probability of younger elderly(aged 60-74)using medical services,but it has no effect on their medical expenditure.Family care has a complementary effect on the use of medical services and medical expenditures in the elderly(75 years old and above).(3)For the elderly with different chronic diseases,family care has a complementary effect on the probability of the elderly without chronic diseases using medical services,but it has no effect on their medical expenditure and hospital stays.Family care has complementary effects on the use of medical services,medical expenditure and hospital stays for the elderly with chronic diseases.Based on the empirical results,this paper proposes policies and suggestions to encourage family care.