The Impact Of Retirement On The Utilization Of Medical Services For The Elderly In China

ObjectivesWith the deepening of China’s aging,the number of retirements is increasing dramatically.All of these can lead to much pressure on public expenditures.Due to this,China implement policies to delay retirement.This study aims to explain the short-term effect of retirement on the utilization of medical services and the impact mechanism of retirement on the health.Furthermore,we try to provide evidence for implementing the delay retirement policy.MethodsThis study used data from the China Health and Retirement Longitudinal Study(CHARLS)in 2013 and 2015.Based on a fuzzy regression discontinuity model,we applied two stage least square(2SLS)to analyze the impact of retirement on outpatient services,inpatient services,self-treatment,health check and medical service satisfaction,and the impact mechanism of retirement on the health,health behavior,income and time cost of the elderly.ResultsRegarding the outpatient service utilization,retirement significantly decrease the rate of forgone outpatient and increase doctor visits per month.And people prefer to get outpatient services in primary healthcare institutions.As for inpatient service utilization,retirement increases the days of hospital stays by almost 3 days per year for women and more than one day per year for men.In contrast to outpatient,people tend to choose general hospitals to be inpatient.The effects on self-treatment cost is substantial,which improve the total and out-of-pocket cost of self-treatment by 92.4%and 81.3%,respectively.After retirement,the medical examination rate dropped by 10.7%,and the satisfaction degree of medical service utilization increased by 24.6%.One possible mechanism is the deterioration of health after retirement,including physical and psychological.As for the effects on healthy behavior,retirement can improves the incidence of socialize.The other one maybe the reduction of time cost.Elderly will significantly increase their use of medical services within one year after retirement and private sector retirees have increased use of healthcare compared to public sector retirees.In heterogeneity analysis,we find living with a partner may help increase the inpatient and outpatient care utilization.And people with lower education are more likely to give up inpatient and outpatient treatment after retirement,and their hospital stays are shorter than those with pension or medical insurance.There is a significant positive effect of retirement on doctor visits for men,but the effect is negative for women.ConclusionsAfter retirement,people increased the utilization of medical services,mainly due to the deterioration of health and the reduction of the cost of time spent on medical treatment.Relevant departments should take measures to improve the medical services and complete the social security system,and ensure the rights of employees of different departments to rest.Policy makers can’t ignore the high co-payment.What’s more,providing more active psychological intervention and carrying out public welfare activities for retirees could improve the happiness of the elderly.All of these can provide an important foundation for promoting healthy aging and ensure the utilization of medical services for the elderly.