Influence of different health-care systems on health of older adults: a comparison of Hong Kong, Beijing urban and rural cohorts aged 70 years and older.
OBJECTIVE
To explore the hypothesis that better health status of elderly populations is primarily determined by the provision of freely accessible health service at low or no cost to the user and a social welfare system.


METHODS
Information was collected by questionnaire from surveys of three cohorts of elderly (70 years and older) Chinese. Data from two health-care systems were compared: the low-cost or free government-subsidized system in Hong Kong, and the market-orientated user-pays system in urban (Beijing), and rural China.


RESULTS
The Beijing rural cohort had the best health profile, whereas the Hong Kong cohort had the worst, despite the better lifestyle practices in the Hong Kong and Beijing urban cohorts compared with the Beijing rural cohort, and higher socioeconomic status in the Beijing urban and Hong Kong cohorts. However, the Beijing rural cohort had the highest prevalence of functional limitations.


CONCLUSIONS
While health-care systems may affect life expectancy at birth, psychosocial, lifestyle and socioeconomic factors influence subsequent health status of elderly people in a complex manner.
Woo
Jean
J
Department of Medicine and Therapeutics, Prince of Wales, Hospital, Shatin, New Territories, Hong Kong. jeanwoowong@cuhk.edu.hk
Zhang
Xin Hua
XH
Ho
Suzanne
S
Sham
Aprille
A
Tang
Zhe
Z
Fang
Xiang Hua
XH
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002681:China; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards* / Q000639:trends; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000592:standards* / Q000639:trends; D006723:Hong Kong; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D012423:Rural Health / Q000592:standards* / Q000639:trends; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000592:standards* / Q000639:trends; D019037:Urban Health Services / Q000458:organization & administration; D014505:Urban Population