The Value of Medical Spending in China, 1991-2019
Author(s)
zhao zhan, M.D.1, Jian Wang, phD2.
1Wuhan University Dong Fureng Institute of Economic and Social, WU HAN, China, 2Wuhan University Dong Fureng Institute of Economic and Social, Wuhan, China.
1Wuhan University Dong Fureng Institute of Economic and Social, WU HAN, China, 2Wuhan University Dong Fureng Institute of Economic and Social, Wuhan, China.
OBJECTIVES: With economic development and urbanization, medical expenses in China have increased dramatically. However, no previous studies have assessed the value of this expenditure growth in China. This study aims to compare gains in life expectancy with increased medical costs in China from 1991 to 2019.
METHODS: We used data from the China Health and Nutrition Survey(CHNS) and the China Family Panel Studies(CFPS) to estimate average medical expenditures by age and gender for 1991, 2000, 2009, and 2019. Life expectancy and survival probabilities for four age groups were obtained from 2024 Revision of the World Population Prospects. We combined age-specific survival probabilities with medical expenditures to calculate lifetime medical spending. To control for non-medical factors affecting survival, we assumed in our base-case analysis that 50% of life expectancy gains were attributable to medical care. Finally, we compared adjusted increases in life expectancy with lifetime medical spending over the same periods.
RESULTS: From 1991 to 2019, life expectancy at birth increased by 9.33 years. Lifetime medical spending, adjusted for inflation, increased by RMB449,911 ($131,215.7 PPP), and the cost per year of life gained was RMB96,444 ($28,118.6). This cost rose from RMB96,444 ($28,118.6) in 1991 to RMB198,885 ($57,982.8) in 2019. Between 1991 and 2019, the average cost per year of life gained at age 15 was RMB148,668 ($43,342.1), at age 45 was RMB160,389 ($46,792.7), and at age 65 was RMB172,894 ($50,372.4). For age 65 specifically, this cost was RMB172,859 ($50,372.4) during 1991-2000, RMB266,210 ($77,604.1) during 2000-2009, and RMB267,623 ($77,992.2) during 2009-2019.
CONCLUSIONS: Although medical spending significantly increased, it has delivered good value. While the incremental cost for people over 65 remains the highest among all age groups, it has shown a stabilizing trend in recent years, reflecting improvements in the efficiency of medical resource utilization.
METHODS: We used data from the China Health and Nutrition Survey(CHNS) and the China Family Panel Studies(CFPS) to estimate average medical expenditures by age and gender for 1991, 2000, 2009, and 2019. Life expectancy and survival probabilities for four age groups were obtained from 2024 Revision of the World Population Prospects. We combined age-specific survival probabilities with medical expenditures to calculate lifetime medical spending. To control for non-medical factors affecting survival, we assumed in our base-case analysis that 50% of life expectancy gains were attributable to medical care. Finally, we compared adjusted increases in life expectancy with lifetime medical spending over the same periods.
RESULTS: From 1991 to 2019, life expectancy at birth increased by 9.33 years. Lifetime medical spending, adjusted for inflation, increased by RMB449,911 ($131,215.7 PPP), and the cost per year of life gained was RMB96,444 ($28,118.6). This cost rose from RMB96,444 ($28,118.6) in 1991 to RMB198,885 ($57,982.8) in 2019. Between 1991 and 2019, the average cost per year of life gained at age 15 was RMB148,668 ($43,342.1), at age 45 was RMB160,389 ($46,792.7), and at age 65 was RMB172,894 ($50,372.4). For age 65 specifically, this cost was RMB172,859 ($50,372.4) during 1991-2000, RMB266,210 ($77,604.1) during 2000-2009, and RMB267,623 ($77,992.2) during 2009-2019.
CONCLUSIONS: Although medical spending significantly increased, it has delivered good value. While the incremental cost for people over 65 remains the highest among all age groups, it has shown a stabilizing trend in recent years, reflecting improvements in the efficiency of medical resource utilization.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR215
Topic
Economic Evaluation, Health Policy & Regulatory, Organizational Practices
Topic Subcategory
Public Spending & National Health Expenditures
Disease
No Additional Disease & Conditions/Specialized Treatment Areas