Pricing End-of-Life Care: The Impact of Disability Trajectory and Gender Differences in China

Qiuju Guo, School of Sociology, Huazhong University of Science and Technology
Yajun Yu, Huazhong University of Science and Technology
Shiyu Zhang, Huazhong University of Science and Technology

Using Chinese Longitudinal Healthy Longevity Survey (CLHLS) data, this study analyzed disability trajectories’ impact on end-of-life costs and their gender differences among 2002-2018 decedents. The research identified three types of disability trajectories in activities of daily living: basic self-care, slow disability, and rapid disability. Of these, the basic self-care type incurred the lowest end-of-life costs, the slow disability type had the highest overall care costs, and the rapid disability type resulted in the highest medical costs during the last year of life. In the basic self-care group, women faced higher end-of-life care costs compared to men. In contrast, women in the rapid disability group incurred lower care costs in the last month before death compared to men, while no significant gender differences were observed in the slow disability group. In the medical costs in the last year of life, women in the slow and rapid disability groups were more likely to incur no or low medical costs, whereas men were more likely to incur high medical costs. This study shed light on the gender inequality in end-of-life costs across different disability trajectory groups, highlighting the need for targeted interventions and support mechanisms to ensure equitable access to services during end-of-life.

Keywords: Health and Morbidity, Gender Dynamics, Inequality, Disadvantage and Discrimination, Population Ageing

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