Prevalence, characteristics, and cost of self-treatment in the middle-aged and elderly: observations from Henan, China

doi:10.1016/j.puhe.2015.02.005

Public Health

Volume 129, Issue 5, May 2015, Pages 597-600

https://doi.org/10.1016/j.puhe.2015.02.005 Get rights and content

Highlights

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This study provided an updated description of self-treatment for the middle-aged and elderly in China.
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Self-treatment remains an important approach for coping with illness and incurs considerable cost.
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Most of the self-treated illness are aging-related and recurrent, with self-medication as the most common treatment approach.
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Demographic and personal characteristics as well as healthcare conditions are associated with prevalence and cost.

Introduction

When facing illness, a person may choose from hospital-based treatment and self-treatment. Self-treatment refers to the scenario where a person uses unprescribed drugs or other approaches to cope with illness conditions. It differs from self-care and self-medication.¹ Self-treatment remains an important approach for illness management, especially in Asia. The goal of this study is to provide an updated description of self-treatment for the middle-aged and elderly (45 years old and above) in China. Some relevant studied in the literature have been focused on self-medication, behavioural factors associated with seeking self-treatment, and very specific subject groups. This study differs from them by investigating self-medication as well as other treatment approaches, by investigating not only pursuit but also characteristics and cost, and by studying the middle-aged and elderly who have worse health conditions and demand more attention. In addition, data on micro and personal characteristics were collected using a survey. Such data provide complementary information to that in governmental databases.

The survey study was approved by a research ethics review committee at the Renmin University of China (RUC) and conducted in August 2013. All samples were collected from three cities, Luoyang, Jiaozuo, and Xinyang, in the Henan province, which is one of the highly-populated, agriculture-dominating, and least-developed areas in China. The first part of survey collected demographic and personal information, and the second part collected information on self-treatment in a period of twelve months, including prevalence, illness conditions, treatment approaches, reasons for pursuing self-treatments, and cost. A total of 1464 subjects finished survey, and the response rate was 68%. Univariate and multi-variate analyses were conducted on prevalence, characteristics, and cost, using S-Plus Version 8.2.

Section snippets

Prevalence

1215 subjects had at least one self-treatment during twelve months, and 504 had more than five. Multi-variate logistic regression was conducted on whether a subject had at least one self-treatment. With the 45–50 year age group as baseline, the 70 + group has an aOR (adjusted odds ratio) of 0.598 (95%CI 0.342–1.045). Married subjects were less likely to have self-treatment (aOR 0.422, 95%CI 0.254–0.701). With no schooling as baseline, the primary school group was more likely to have

Characteristics

Some results are presented in Fig. 1. Among the 1215 subjects that had self-treatments, 710 had upper respiratory tract infections, 283 had hypertensions, 215 had cardiovascular and cerebrovascular diseases, and 165 had stomach and digestive diseases. Other diseases include cervical disease and osteoporosis, diabetes, arthritis, and rheumatism, with fewer counts. 1177 subjects took self-medication. The second most common approach is folk treatment (for example, scrapping and acupuncture, 108

Expenditure

For the subjects with self-treatments, the average treatment-related cost is 1119.4RMB, the average total cost is 1223.2RMB, and the average OOP (out of pocket) cost is 1106.9RMB. It is found that certain age, education, and occupation groups had significantly higher cost. Subjects in the rural areas had significantly lower cost (over 500RMB less for all three costs). The presence of chronic diseases is significantly positively associated with cost.

Discussions

China has been devoting major effort to improving the healthcare system.² This study is unique in that it is one of the first to study multiple aspects of self-treatment for the middle-aged and elderly. A major finding is that self-treatment remains a common way of dealing with illness. Beyond health conditions, personal characteristics are also found significantly associated with prevalence, and the findings are similar to those in the literature.³ Healthcare accessibility and health insurance

Acknowledgements

We thank the survey staff and participants for their contributions and the editor and reviewer for careful review and insightful comments.

Ethical approval

The study was approved by a research ethics review committee at the RUC.

Funding

This work was supported by Yale MacMillan Center Faulty Research award; Renmin University of China Scientific Research Project Funding: Policy Evaluation of Pension and Medical and Social Security in China (12XNI003); National Social Science Foundation of China (13&ZD164).

Competing interests

None.

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^d: These authors contributed equally to this work.

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Short CommunicationPrevalence, characteristics, and cost of self-treatment in the middle-aged and elderly: observations from Henan, China

Highlights

Introduction

Section snippets

Prevalence

Characteristics

Expenditure

Discussions

Acknowledgements

Ethical approval

Funding

Competing interests

First page preview

Public perception on the role of community pharmacists in self-medication and self-care in Hong Kong

BMC Clin Pharmacol

China. World's biggest health care system goes under the knife

Science

Factors associated with health-seeking behavior among migrant workers in Beijing, China

BMC Health Serv Res

(2012) econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso

Health Policy Plan

Short Communication
Prevalence, characteristics, and cost of self-treatment in the middle-aged and elderly: observations from Henan, China