ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1666119
Economic Burdens of Health Expenditure for Multi-Morbidity of Older People with Hypertension in China and Vietnam
Provisionally accepted
- 1Health Strategy and Policy Institute, Hanoi, Vietnam
- 2Duke Kunshan University Global Health Program, Suzhou, China
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ABSTRACT Background Hypertension is prevalent in older adults and often coexists with other chronic diseases, increasing healthcare costs, especially in low-and middle-income countries (LMICs) like China and Viet Nam. These nations are experiencing rapid population aging, yet comparative evidence on the economic burden of hypertension-related multimorbidity is lacking. Objective(s) This study aimed to compare the financial burden, measured by out-of-pocket health expenditures (OOPHE) and catastrophic health expenditures (CHE), associated with hypertension and common comorbidities (joint disease, heart disease, diabetes) among older adults in China and Viet Nam. Methods Researchers analyzed data from national surveys in China (2018) and Viet Nam (2020) for adults aged 60+. They categorized hypertensive individuals by comorbidities and used regression models to assess the link between these disease clusters and OOPHE and CHE, adjusting for socioeconomic factors. CHE was defined as health spending at or above 40% of a household's capacity to pay. Findings Comorbidities were common in both countries. In China, CHE prevalence was highest for individuals with hypertension and heart disease (30.8%), which was the comorbidity posing the greatest financial risk. In Viet Nam, the hypertension-diabetes cluster had the highest CHE risk (13.5%). In China, all comorbidity groups were associated with higher OOPHE. In
Keywords: Hypertension, multimorbidity, Financial burden, older adults, Low and Middle IncomeCountries
Received: 15 Jul 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Nguyen, Nguyen, Li, Nguyen, Tran and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chenkai Wu, Duke Kunshan University Global Health Program, Suzhou, China
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