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Modeling multi-state health transitions in China: A generalized linear model with time trends

Elderly couple

Katja Hanewald, Han Li and Adam W. Shao

Rapid population aging in China has urged the need to understand health transitions of older Chinese to assist the development of social security programs and financial products aimed at funding long-term care. In this paper, we develop a new flexible approach to modeling health transitions in a multi-state Markov model that allows for age effects, time trends and age-time interactions.

The model is implemented in the generalized linear modeling framework. We apply the model to evaluate health transitions of Chinese elderly using individual-level panel data from the Chinese Longitudinal Healthy Longevity Survey for the period 1998–2012. Our results confirm that time trends and age-time interactions are important factors explaining health transitions in addition to the more commonly used age effects.