Determinants of life expectancy with unmet needs in the Chinese older population (revision 1)

Abstract

Abstract This study investigates the determinants of and disparities in life expectancy (LE) with unmet long-term care needs among older people in China. The data come from four waves of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey conducted between 2013 and 2020 (N = 42,480). Continuous time multi-state Markov modelling is combined with the life table approach to estimate the total life expectancy and life expectancy with met and unmet needs. Chinese older people aged 60 are expected to spend an average of 2.02 years with unmet care needs, comprising about one-third of their LE with care needs (6.44 years). LE with unmet needs is significantly longer among women, single people, older people with a lower level of education, and those living in rural areas. The duration of unmet needs over the remaining lifetime is estimated to be more than three times longer among the most disadvantaged group than the most advantaged group of older people (3.40 years vs 1.07 years). Life expectancy with unmet needs provides important information about older people’s quality of life and, like (un)healthy life expectancy, can be used for health economic evaluations and to monitor the performance of a health and care system. Targeted policies and interventions designed to support disadvantaged groups are essential to reduce the lifetime disparities in unmet needs.