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• W3093902339 abstract "IntroductionThe rapidly rising burden of non-communicable diseases (NCDs) in China affects the demand for healthcare services among households and threatens to create an increased financial burden on households, at a time when economic growth has been slowing down and traditional forms of inter-generational support are in decline. However, the design of effective policies to address household impacts of NCDs in China is hindered by a lack of high-quality work on the economic roots of NCDs, the impact of NCDs on households and economic gains that might result from policy action to address NCDs. This thesis aims to fill this gap by investigating the association between socio-economic characteristics and behavioural risk factors and NCD onset, by estimating the economic consequences of NCDs on current and future household welfare associated with coping strategies and by estimating the economic consequences of delayed treatment for NCDs. MethodsThis thesis consists of three quantitative analyses, all of which use longitudinal datasets. Study One uses three waves of longitudinal data from the China Family Panel Studies survey (CFPS, 2010-2014) and a dynamic model conditional on not having an NCD in the initial period to estimate the effects of behavioural and socio-economic risk factors on the onset of NCDs among individuals in China. Study Two uses the same dataset from CFPS over 2010 and 2014 and fixed-effect models to examine whether households in China can maintain consumption expenditures in the face of a new NCD diagnosis and how the households cope with the diseases and the consequences of the coping mechanisms. Study Three draws data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) and applies difference-in-differences (DID) methods on a matched dataset of individuals to estimate the effects of variation in treatment timing (i.e. early versus late treatment) on healthcare use and health spending among individuals newly diagnosed with hypertension. ResultsStudy One shows that being obese, using solid cooking fuels, a history of frequent drinking, and a higher level of household total consumption expenditure during the preceding period were positively associated with NCDs. More importantly, through disaggregating the effects by age subgroups, it shows that some risk behaviours one established decades ago (such as frequent drinking) have long-term and accumulative effects on health, even people have changed behaviour at older ages. Study Two reveals that (non-poor) Chinese households that experienced a substantial increase in out-of-pocket (OOP) health expenditures following an NCD shock can smooth consumption expenditure, through the depletion of housing assets and receipt of public transfers. For poor households, there was no significant increase in health expenditures and no effects on household consumption and assets, suggesting that they might abandon treatment. Both the non-poor and poor were paying the price, the first group in terms of future wealth and the second in terms of health. Study Three suggests that patients who started treatment late spent more on health services and were more likely to incur catastrophic health expenditures (CHE) once they initiated treatment, relative to counterparts who began hypertension treatment earlier. Hypertensive patients having started treatment earlier experienced declines in the probability of incurring health expenditures in the subsequent period.ImplicationsIn conclusion, NCDs have a long-term impact on household welfare in China. Ignoring the economic cost associated with coping with NCDs and with delayed NCD treatment, can underestimate the costs in the future. Public intervention policies to address the emerging risks of NCDs at an early stage, and insurance policies to protect individuals and households from potentially catastrophic expenses of treating NCDs are needed." @default.
• W3093902339 created "2020-10-29" @default.
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• W3093902339 date "2019-01-01" @default.
• W3093902339 modified "2023-09-27" @default.
• W3093902339 title "The Economic Impact of Non-communicable Diseases on Household Welfare in China" @default.
• W3093902339 hasPublicationYear "2019" @default.
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