Behavior
Medical expenditure attributable to short sleep in China: Empirical results based on the 2018 China Family Panel Studies Xiaoyu Li* Xiaoyu Li Xumeng Yan Fang Han Ichiro Kawachi
Background
Short sleep is associated with increased morbidity risks and therefore can induce substantial medical costs. This study estimates the total and out-of-pocket amount of medical expenditure attributable to short sleep among Chinese adults.
Methods
Using a 2018 nationally representative Chinese dataset, we employed two-part regression models to examine the associations between short sleep (<6h, 6-7h vs >7h) and annual total or out-of-pocket medical expenses. Counterfactual estimations were used to estimate individual and population medical cost due to short sleep.
Results
The mean age of participants was 46.6 years (SD = 16.7), with 50.1% of them being male. Among 29118 participants, 2,037 (7.0%) slept less than 6 hours, 8,457 (29.0%) slept 6 to 7 hours, and 18624 (64.0%) slept more than 7 hours per day. Those sleeping <6 hours had higher odds of medical expenditure (OR = 1.28, 95% CI: 1.14, 1.43), and when they did, they spent 1,438.05 CNY (95% CI: 991.23, 1884.87) more than those sleeping > 7 hours. The corresponding estimates for out-of-pocket medical expenditure were 1.27 (95% CI: 1.14, 1.42) and 905.16 CNY (95% CI: 632.46, 1177.86). Short sleep (< 6 h) accounted for 3.25% of the expected total medical expenditure and 3.20% of the expected out-of-pocket medical expenditure for an average person. The share of medical spending due to short sleep is higher in groups who were female, divorced/widowed, poorly educated, living in rural residential areas, and working on farming jobs. In 2018, China’s total medical expenditure attributable to short sleep (< 6 h) was estimated to be 106.31 billion CNY (16.36 billion USD), of which 65.78 billion CNY (10.12 billion USD) was out-of-pocket (61.88%).
Conclusion
Short sleep was associated with increased medical expenses in China. Promoting adequate sleep can potentially mitigate healthcare costs, especially for vulnerable populations.