The association between voluntary health insurance and health outcomes in older adults in Europe: A survival analysis

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-11-09 DOI:10.1016/j.puhe.2024.10.031

Yamato Uejima , Filippos T. Filippidis , Thomas Hone , Christopher Millett , Raffaele Palladino

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引用次数: 0

Abstract

Objectives

Voluntary health insurance (VHI) often serves a supplementary role in Europe. The ageing population and adoption of cost-sharing models in response to economic pressures raise concerns that VHI could contribute to health inequalities among older people. This study investigates the association of VHI with health outcomes among older people across 16 European countries and Israel.

Study design

Prospective cohort study.

Methods

Data on participants aged ≥50 years across 16 European countries and Israel were obtained from four waves (2013–2020) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Gompertz proportional hazards models assessed the association of VHI with mortality and multimorbidity. Hazard ratios (HR) and 95 % confidence intervals (CI) are reported.

Results

VHI prevalence was 38.2 % in 2013 and 34.9 % in 2015, with a higher prevalence among higher-income groups. VHI was associated with a 13 % lower risk of mortality (HR: 0.87, 95% CI: 0.81–0.94) after accounting for demographic, socioeconomic, lifestyle, and health-related factors. VHI was also associated with a lower risk of multimorbidity (HR: 0.92, 95 % CI: 0.87–0.97).

Conclusions

VHI was associated with a reduced risk of mortality and multimorbidity, after adjusting for demographic, socioeconomic, lifestyle, and health-related factors. VHI might facilitate the access to timely and high-quality healthcare services, which may exacerbate health inequalities among older individuals.

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欧洲老年人自愿医疗保险与健康结果之间的关系：生存分析。

目的：在欧洲，自愿医疗保险（VHI）通常起到补充作用。人口老龄化和为应对经济压力而采用的费用分担模式使人们担心自愿医疗保险可能会导致老年人之间的健康不平等。本研究调查了 16 个欧洲国家和以色列的自愿医疗保险与老年人健康结果之间的关系：研究设计：前瞻性队列研究：16 个欧洲国家和以色列年龄≥50 岁的参与者的数据来自四次欧洲健康、老龄化和退休调查（SHARE）（2013-2020 年）。贡珀兹比例危险模型评估了自愿健康指数与死亡率和多病症的关系。报告了危险比（HR）和 95 % 置信区间（CI）：2013年和2015年的VHI患病率分别为38.2%和34.9%，高收入群体的患病率更高。在考虑人口、社会经济、生活方式和健康相关因素后，VHI 与死亡率风险降低 13% 相关（HR：0.87，95% CI：0.81-0.94）。结论：VHI 也与多病风险降低有关（HR：0.92，95 % CI：0.87-0.97）：在对人口、社会经济、生活方式和健康相关因素进行调整后，自愿住户健康保险与死亡率和多病风险的降低有关。老年人健康保险可能有助于老年人获得及时、优质的医疗保健服务，这可能会加剧老年人之间的健康不平等。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.