Research on influence of physical activity on medical expenditure in the elderly in China—Based on CHARLS in 2015

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In this work, Tobit model is established based on the data from China Health and Retirement Longitudinal Study in 2015 and Behavioral Model of Health Services Use theoretical framework. Compared with the inactive elderly, the medical expenditure of the elderly who participate in the level 4, 3, 2 physical activity decreasing step by step. After involving need factors in the model, the influence of physical activity on medical expenditure varies from significant to insignificant. The medical expenditure of the elderly who meet the physical activity amount is negatively correlated with the physical activity amount, and is lower than that of the elderly who don’t meet physical activity amount. Physical activity will not directly affect medical expenditure, but will affect medical expenditure through chronic diseases and self-rated health status. Our results provide theoretical analysis and empirical test for enriching physical activity guidelines and Behavioral Model of Health Services Use in the elderly in China. Health Economics & Outcomes Research Health Policy aging elderly medical burden Figures Figure 1 Introduction In recent years, the aging speed in China continues to accelerate. According to the latest data released in January 2020 by the National Bureau of statistics, by the end of 2019, the population aged 60 and above has reached 253.88 million, accounting for 18.1% of the total population, far exceeding 10% of the social standard line for aging. The aging population has brought a serious burden to our society. According to the latest data of the National Bureau of statistics, the total national medical expenditure in 2018 was about 5.9 trillion yuan, increasing by 12.4% compared with that in 2017, and the per capita health expenditure was 4237.0 yuan, increasing by 12.0% compared with that in 2017 1-2 . The factors influencing medical expenditure are complex, and physical activity is one of the changeable factors. In the field of sport science research, Yang Guang et al. 3 conducted a factor analysis on the influence of physical activity on medical expenses in the elderly in Hegu area of Sendai Japan, through questionnaire survey; Li Wenchuan 4 conducted an empirical study on the reduction of medical expenditure by physical exercise of the elderly in Shanghai. Lehnert t et al. 5 pointed out that the utilization of medical services is mainly related to physical factors in health conditions, rather than psychological factors. Physical factors mainly refer to chronic disease conditions, physical function conditions and physical activities. Guo Jialiang et al. 2 believe that among the many factors influencing the health and health expenditure of the elderly, physical activity is also becoming one of the main influencing factors. Compared with other factors, physical activity is the most promising factor to be improved through action 6 . Based on the cross-sectional data of China Health and Retirement Longitudinal Study (CHARLS) in 2015, this paper uses the Behavioral Model of Health Services Use (BMHSU) and Tobit model to study the relationship between physical activity and medical expenditure of the elderly, and try to analyze the relationship between the frequency, intensity, duration and form of physical activity and medical expenditure of the elderly. Methods Study design. When studying the influencing factors of personal medical expenditure, health status is regarded as the most direct influencing factor. Hu Hongwei et al. believe that chronic diseases and self-rated health significantly affect the medical expenditure of the elderly 7,8 . In addition to health status factors, Liu Guoen et al. believe that the income, medical insurance and pension of the elderly will also influence their medical expenditure 9-11 . In addition, education level, marital status, age, gender and urban and rural identity will also influence medical expenditure 7,11 . According to the research on the impact of physical activity on medical expenditure of the elderly, scientific physical activity has significant effect on reducing the incidence of diseases, reducing medical demand and saving medical expenditure 12 . According to the intensity, amount and duration of exercise, Yang Guang 3 divided the amount of physical activity of the elderly over 70 years old in the Hegu area of Sendai Japan into three levels. With the decrease of intensity and amount of exercise, there are significant differences in medical expenditure among the three groups. In summary, the factors that affect the personal medical expenditure of the elderly in China are relatively complex, involving health status, economic conditions, social security, socio-demographic characteristics, physical activities and many other aspects. Professor Andersen's BMHSU provides a comprehensive and systematic theoretical framework for the research in this field. In this dynamic and interactive relationship model (Figure 1), demographic characteristics affect medical expenditure, and personal health practices affect demographic characteristics. Demographic characteristics include three aspects: need factors, enabling resources and redisposing characteristics 13 . In addition to the medical service utilization behavior, the health behavior in the theoretical model also includes personal health practices, such as diet and exercise 14 . Domestic scholars have systematically introduced the theoretical model 13,15 . Song Lu et al. used the model to explore the influencing factors of rural elderly medical expenditure from the perspective of gender difference 16 ; Liu Guoen et al. 9 empirically analyzed the impact of medical security on medical service demand of the elderly's from three dimensions of need, enabling resources and predisposing characteristics based on the theoretical model. Ma Aixia et al. 7 established Tobit model about influencing factors of medical expenditure of the elderly in China based on the model framework. However, no studies have yet incorporated physical activity into the theoretical model. Taking Andersen theoretical model as the research framework, on the premise of controlling predisposing characteristics, enabling resources and need factors, this paper will conduct empirical research on the correlation between physical activity variables in personal health practicess and medical expenditure, promote the further improvement of the theoretical model, and provide reference for the development of related research in China. Data source. The data used in this paper are the cross-sectional data of China Health and Retirement Longitudinal Study (CHARLS) of National School of Development of Peking University in 2015. The sample covers 21000 respondents from 12400 families. The survey subjects are mainly the micro data of families and individuals aged 45 and above in China and the survey contents include basic information, health status and function, medical care and insurance, work, retirement and pension, of which physical activity variable is a secondary sampling survey. After excluding the samples under 60 years old and lack of relevant variables and secondary sampling, 4093 samples are eventually used in this paper. Selection of variables. The per capita medical expenditure of the elderly is the dependent variable of this study, which is the sum of the monthly outpatient expenditure and the annual hospitalization expenditure in the questionnaire 7,17 , including the reimbursement of medical insurance and the part of individual self-payment. According to BMHSU, fifteen variables including need factors, enabling resources, predisposing characteristics, personal health practices and the use of medical services are selected as independent variable and control variable (Table 1), of which personal health practices mainly select sports dimension, including four levels of physical activity. Physical activity refers to any physical activity that results in energy consumption caused by skeletal muscle contraction, which is composed of four types of physical activities: occupational, traffic, housework and leisure 18,19 . Intensity, duration weekly and duration each time are used as index to measure physical activity 20 . The impact of physical activity on health depends on the way, intensity, duration, frequency and total amount of physical activity 21 . In this study, the selection of independent variable ——four levels of physical activity is derived from the question of "physical activity" in the 2015 CHARLS questionnaire: "How long do you usually take in these activities (including high intensity, medium intensity and walking) in a week?". According to WHO physical activity guidelines for the elderly 25 , Chinese adult physical activity guidelines of at least 30 minutes per day, Chinese Ministry of Health's proposal of "ten thousand steps per day", and the related research on physical activity amount, the independent variables are divided into four levels 3 , and the level 4 physical activity group includes: high intensity exercise (more than 75 minutes per week, no less than 10 minutes each time), moderate intensity exercise (more than 150 minutes per week, no less than 10 minutes each time), and walking (210 minutes a week, no less than 10 minutes each time); The level 3 physical activity group includes: no high intensity exercise, moderate intensity exercise (more than 150 minutes per week, not less than 10 minutes each time), walking (210 minutes a week, not less than 10 minutes each time); The level 2 physical activity group includes: no high and moderate intensity exercise, walking (210 minutes a week, not less than 10 minutes each time); The level 1 physical activity group includes: the elderly who doesn’t meet the above three levels of intensity. The level 1 physical activity group doesn’t meet the physical activity, the other three groups meet the physical activity. Table 1 Definition of variables Measured content Variables Measured index Need factors Self-rated health Excellent=4，Good=3，Normal=2，Bad=1，Very bad=0 Disability Yes=1，No=0 Chronic disease Yes=1，No=0 Enabling resources Medical insurance Yes=1，No=0 Pension Yes=1，No=0 Personal income All income in last year (continuous variable) Predisposing characteristics Gender Male=1，Female=0 Age 60-69=0, 70-79=1, 80 and above=2 Education level Illiterate=0, Primary school (including private school)=1, Middle school=2, High school and above=3 Marital status Married and cohabiting with spouse =1, Others=0 City or rural City=1, Rural=0 Personal health practices 4 levels physical activity Level 4 PA group=3, Level 3 PA group=2, Level 2 PA group=1, Level 1 PA group=0 Per capita medical expenditure Monthly outpatient expenditure and annual inpatient expenditure Annual per capita medical expenditure (continuous variable) Tobit Model. Based on the data characteristics and the application study of Tobit model by demography related scholars 7,22,23 , this paper will establish Tobit model of influencing factors of the elderly medical expenditure. Ethics approval and consent to participate. For all experiments on humans, we confirm that all methods were carried out in accordance with relevant guidelines and regulations. The CHARLS received ethics approval from both a national government administration and an institutional review board or ethics committee. Only adolescents who provided written/verbal consent participated. As the current study used retrospective publicly available data, we did not require ethics approval from any Institutional Ethics Review Committee for this secondary analysis. The CHALRS questionnaire refers to international experience, including the American Health and Retirement Survey (HRS), the British Elderly Tracking Survey (ELSA), and the European Health, Old Age and Retirement Survey (SHARE), etc. Multi-stage sampling is adopted in the project, and PPS sampling method is adopted in both county/district and village sampling stages. The response rate and the quality of CHARLS data are among the best in similar projects in the world, and the data has been widely used and recognized in academia. Results Comparison of physical activities of the elderly with different characteristics The data shows that there are significant differences in medical expenditure, gender, education level, marital status, pension, self-rated health status, and whether there is disability or not (Table 2). The medical expenditure and physical activity of the elderly who meet the physical activity shows a negative correlation trend; the proportion of men in level 4 physical activity group is higher than that in the other three groups; the education level of the elderly who meet the physical activity amount is higher than that in the elderly with insufficient physical activity; the self-rated health status of the elderly who meet the physical activity amount is more positive than that in the elderly who doesn’t meet the physical activity. For the elderly who don’t meet the physical activity amount, the majority of them are women, whose age are higher than the average age, which is 70.52 years old. Their education levels are mainly below primary school, and cohabiting with spouse are also below the average level. The proportion of buying medical insurance and insurance is relatively low, and the personal income is lower than the average level. The self-rated health status is relatively negative, and the proportion of disabled people is more than a half. According to the physical activity of the disabled elderly, 80.41% of them meet the physical activity, and the number of persons participating in the second, third and fourth level physical activity is distributed more evenly, which indicates that most of the disabled elderly have certain demand for physical activity. For the elderly patients with chronic diseases, 84.48% of the elderly meet the physical activity level, and the number of persons participating in the second, third and fourth level of physical activity is distributed more evenly. Among the four groups of elderly physical activity, there are no statistically significant differences in the comparison of physical intensity in the five indicators of age, urban and rural household registration, personal income, medical insurance and whether there is chronic disease. Table 2 Group difference of four levels of physical activity in the elderly Measured content Variables Average value F/X 2 value Meet physical activity amount Do not meet physical activity amount Level 4 PA Level 3 PA Level 2 PA Level 1 PA Numbers（N/%） 1205（29.44） 1088（26.58） 1174（28.68） 626（15.29） Independent variable Annual medical expenditure 9061 23479 26165 22509 12.40 *** Predisposing characteristics Male（%） 57.43% 43.47% 49.40% 45.85% 16.65 *** Age 66.25 67.38 69.38 70.52 85.40 Education level 1.00 1.15 1.12 0.86 19.34 *** Married with spouse （%） 83.98 77．30 76.40 72.04 13.55 *** Urban residence 0.12 0.33 0.34 0.21 70.62 Enabling resources Medical insurance（%） 92.45 94.67 92.08 87.22 10.29 Pension（%） 74.19 75.92 70.70 69.65 4.10 *** Personal income（元） 2061.87 1437.71 1426.50 1344.10 4.96 Need factors Self-rated health 2.18 2.16 2.08 1.86 20.11 *** Disability(%） 39.17 34.65 41.65 52.08 17.43 *** Chronic disease（%） 72.86 74.45 71.81 74.28 0.82 Note: ***: P<001; **: P<0.05; *: P<0.1 Results of Tobit model According to model 1, physical activity of the elderly will significantly influence the medical expenditure of the elderly in China. The lower the physical activity, the higher the medical expenditure of the elderly (Table 3). In model 2, predisposing characteristics are included. The results show that all levels of physical activity still had significant impact on medical expenditure of the elderly in model 2. In model 3, the enabling resources are also included in the model to analyze the influence of various dimensional variables on medical expenditure of the elderly when they access to medical services and resources. The results show that personal income will significantly influence the medical expenditure of the elderly, which is consistent with that personal income is the most important factor in relevant research 23 ; the medical expenditure of the elderly with income is 1.03 times as much as that of the non-income, while physical activity, education level, marital status and urban or rural identity still have a significant impact on the medical expenditure of the elderly. Compared with the elderly with the level 1 physical activity, the elderly who participate in level 4, level 3 and level 2 physical activity will reduce medical expenditure by 15134.92 yuan, 10828.5 yuan and 3903.13 yuan respectively. Participating in physical activities will reduce the medical expenditure by 5298.67 yuan. In model 4, the need factors were included in the post analysis, and the self-rated health status of the elderly significantly influences the medical expenditure of the elderly in China. In addition, disease is the most direct influencing factor, and the average annual medical expenditure of elderly patients with chronic diseases is 2965.51 yuan, while that of the elderly without chronic diseases is only 1637.52 yuan. Whether or not suffering from disability has no significant impact on the medical expenditure of the elderly. It is worth noting that education level, marital status, personal income, self-rated health status, whether suffering from chronic diseases still have significant impact on medical expenditure of the elderly in model 4, but physical activity has no significant impact on medical expenditure of the elderly. In the related research on the influencing factors of medical expenditure of the elderly, the two-categorical variable of physical exercise——"yes or no" is included in the model study, and the result is also not significant 24 . Table 3 Tobit model of medical expenditure of the elderly in China Variables Model 1 Model 2 Model 3 Model 4 Independent variable Physical activity -4865.68 *** -5555.37 *** -5298.67 *** -2756.12 Level 2 PA -4368.31 * -4269.57 * -3903.13 * 1894.832 Level 3 PA -10905.07 * -11393.51 * -10828.5 * -3077.957 Level 4 PA -14055.53 ** -15947.47 ** -15134.92 *** -6550.634 Predisposing characteristics Gender -4728.08 -3610.24 -1371.10 Age -98.70 203.80 -712.19 Education level 3038.37 * 3249.54 * 4351.12 * Marital status 10520.69 ** 10369.45 ** 10108.73 ** Urban or rural -9778.96 ** -9937.97 ** -4214.77 Enabling resources Medical insurance -7757.82 -8164.82 Pension 2400.06 2339.13 Personal income -1308.75 ** -883.20 * Need factors Self-rated health status -25757.08 *** Disability 2395.01 Chronic disease 14458.73 *** N 4093 4093 4093 4093 Logarithm Likelihood function -7602.5799 -7597.026 -7593.3991 -7507.2194 P-value 0.0043 0.0037 0.0017 0.0000 Note: ***: P<001; **: P<0.05; *: P<0.1 Discussion In the whole life course, physical activity is closely related to health. A large number of cross-sectional studies and longitudinal studies have shown that the relative risk of limited activity function is reduced by 50% among people who regularly participate in at least moderate intensity of physical activity. For the elderly, physical activity can reduce anxiety and depression and improve self-confidence by maintaining muscle strength and cognitive ability. Randomized controlled trials show that physical activity can increase social participation, maintain social networks and intergenerational connectivity. In addition, a large number of literature shows that physical activity has an impact on health status, but this study concluded that due to the impact of health, the influence of physical activity on medical expenditure is significant or insignificant. In Tobit model 4, after adding the need factors, there are statistical effects on influence of health and whether suffering from chronic diseases on the elderly medical expenditure, which also proves the direct impact of health on medical expenditure. The self-rated health status of the elderly will significantly influence the medical expenditure of the elderly in China. The more negative the self-rated health status is, the higher the medical expenditure is. Maybe when the elderly self-rated health status is poor, outpatient treatment is frequent 26 . In addition, disease is the most direct influencing factor. The prevalence of chronic diseases in the elderly in China is relatively high, with an average of 1.68 chronic diseases, of which 73.21% suffer from one or more chronic diseases. Elderly patients with chronic diseases have a long and large demand for medical care. In addition, once the chronic diseases recur, the treatment cost is very expensive 23 . It also further shows that the average annual medical expenditure of the elderly patients with chronic diseases is higher than that of the healthy elderly. Whether suffering from disabilities has no significant impact on the medical expenditure of the elderly, which is the same as Ma Aixia's analysis. The reason may be that most disabilities, such as physical disability, deafness and blindness, do not need continuous medication or hospitalization, so the impact on medical expenditure is limited 6 . The study also finds that the higher the education level is, the higher the medical expenditure is. The medical expenditure of the elderly with diploma of primary school, middle school, high school and above are 1.01, 1.34 and 1.77 times of that of illiterate people respectively and higher education level increases the ability of the elderly to use medical services 27 , which is the same with Liu Guoen et al.’s study result that income has a significant impact on medical expenditure, and the medical expenditure of high-income population is significantly higher than that of the low-income population 10 . The higher the income level of the elderly is, the more attention they pay to their health status, so the medical expenditure is more 23 . According to the results of one-way ANOVA of physical activity of the elderly with different characteristics, the medical expenditure and physical activity of the elderly who meet the amount of physical activity show a negative correlation. At the same time, Tobit model 1 shows that physical activity has a significant impact on medical expenditure. The medical expenditure of elderly people who participate in high-intensity or moderate intensity exercise and walking exercise is far lower than those who only participate in walking exercise and who walk for 210 minutes or more a week, that is there is a difference medical expenditure between the elderly people who participate in walking only and those who participate in middle and high intensity of physical exercise. By reviewing the literature in sports about the impact of physical activity on medical expenditure in China, it is found that the research in this field is still in its infancy. Yang Guang 3 and Yang Wenchuan 4 et al. found that physical activity played an important role in restraining the growth of medical expenditure. And the related foreign research also confirmed this result. On one hand, insufficient physical activity will influence medical expenditure. Ding et al. 28 estimated that the global lack of physical activity in 2013 had led to an increase of about 53.8 billion US dollars in global health care expenditure. On the other hand, regular physical activity is helpful to relieve the pressure of medical expenditure. Ackerman et al. 29 used a retrospective cohort study and found that the average annual medical expenditure of the elderly over 65 years old who participated in community exercise programs in the past three years was far lower than that of those who did not regularly participate in physical exercise. However, there is a lack of research on the difference of medical expenditure between walking and middle or high-intensity exercise. In addition, because predisposing characteristics will not directly influence personal medical expenditure, but indirectly play a role through influencing enabling resources and need factors 8 , as the basis in building model, the predisposing characteristics are analyzed firstly and included the direct influencing factors——need factors in this paper. In this study, because the occurrence of diseases or the decline in health status are the prerequisites and direct influencing factors for individuals to use medical services 8 , therefore, with the addition of need factors in model 4, the impact of physical activity changes is significant to insignificant. To a certain extent, physical activity will not directly influence medical expenditure, but may influence that by chronic diseases and self-rated health status, which confirms the exploration of the dynamic relationship between health behavior and demographic characteristics by BMHSU model from the side 14 . Through many quantitative empirical studies, scholars at home and abroad have shown that there is a certain correlation between physical activity and medical expenditure of the elderly, but they have not explained the influencing path at the same time. At present, some studies take health-related variables as mediation factors for path analysis. A public health survey in Sweden studied the mediation role of self-rated health between physical activity and medical service utilization through path analysis 30 . The influence of physical activity on medical expenditure is a long-term effect, so it is suggested that the elderly should be encouraged to improve their need factors through physical activity, thus affecting medical expenditure. However, for its mechanism, it is suggested to use path analysis to explore, which can be further demonstrated in future research. Declarations Data availability The data that support the findings of this study are available from National School of Development, Peking University. Restrictions apply to the availability of these data, which were used under license for this study. Data are available at http://charls.pku.edu.cn/pages/data/111/zh-cn.html with the permission of Peking University. Competing interests The authors declare no competing interests. Acknowledgements We gratefully acknowledge National School of Development of Peking University and China Center for Economic Research Institute of Social Science Survey of Peking University for providing China Health and Retirement Longitudinal Study (CHARLS) data. Author contributions C. Hong conceived the design and performed statistical analysis and F. Wu performed the figure generation. All authors reviewed the manuscript. 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Peking University China Social Science Survey Center, 2018, China Health and Retirement Longitudinal Study (2015), http://opendata.pku.edu.cn/, Peking University Open Research Data Platform, V1 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-124062","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":7147566,"identity":"7e9f396a-670a-4ee4-8c28-4db106465cf6","order_by":0,"name":"Chenlu Hong","email":"","orcid":"","institution":"Peking University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chenlu","middleName":"","lastName":"Hong","suffix":""},{"id":7147567,"identity":"21f482af-19ee-4118-9567-c849a5786fb0","order_by":1,"name":"Fei Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuklEQVRIiWNgGAWjYFACxgcMCRUMBiCmBJFamA0YEs6QrIWxjRQtBjeSGR88nHfH2OAA88HbPAx2ecRoYTZI3PbMzOAAW7I1D0NyMUEtZjfyj0kkbjtsY3CAx0yah+FAYgNhLcnsPxLngLTwfyNaCxtDYsNhoMN42IjTYn/mMbNEwrFnxpKH2Ywt5xgkE9Yi2Z7M+PFHzR3DvuPND2+8qbAjrAUKDgDjB0QbEKkeomUUjIJRMApGAS4AANUqPKUoSY/iAAAAAElFTkSuQmCC","orcid":"","institution":"Peking University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Fei","middleName":"","lastName":"Wu","suffix":""}],"badges":[],"createdAt":"2020-12-08 08:14:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-124062/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-124062/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":4574776,"identity":"8ae7483c-01e4-44f9-922f-87f9d207e1bb","added_by":"auto","created_at":"2020-12-29 15:29:46","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":52319,"visible":true,"origin":"","legend":"Phase 4 of Behavioral Model of Health Services Use 14. The model of health service’s use such as the use of medical care is a function of the elderly with perceived need and predisposition to use services while some factors enable or impede the use. And it also recognizes personal health practices such as physical activities as interacting with the need factors and the use of health services. Among the predisposing characteristics, demographic factors such as age and gender represent biological factors suggesting the likelihood that the elderly will need health service. Social structure is measured by factors include education, marriage and hukou (living in rural or urban) that determine the status of the elderly in the community; Among enabling resources, personal resources and community resources are both included. Health resources should be available where the elderly live and work and the elderly must have the ability and means to get to those services include income, medical insurance and pension; Among need factors, the elderly will get to health service like medical care with the perceived need including self-rated health and chronic diseases.","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-124062/v1/5cf261b1be95b2e5ac3ed221.jpg"},{"id":13640628,"identity":"7110bddc-162d-4786-904c-9537040dde2a","added_by":"auto","created_at":"2021-09-17 09:00:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":285707,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-124062/v1/09f44bde-134f-4acb-83a1-e48ad1d8a681.pdf"}],"financialInterests":"","formattedTitle":"Research on influence of physical activity on medical expenditure in the elderly in China—Based on CHARLS in 2015","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, the aging speed in China continues to accelerate. According to the latest data released in January 2020 by the National Bureau of statistics, by the end of 2019, the population aged 60 and above has reached 253.88 million, accounting for 18.1% of the total population, far exceeding 10% of the social standard line for aging. The aging population has brought a serious burden to our society. According to the latest data of the National Bureau of statistics, the total national medical expenditure in 2018 was about 5.9 trillion yuan, increasing by 12.4% compared with that in 2017, and the per capita health expenditure was 4237.0 yuan, increasing by 12.0% compared with that in 2017\u003csup\u003e1-2\u003c/sup\u003e. The factors influencing medical expenditure are complex, and physical activity is one of the changeable factors. In the field of sport science research, Yang Guang et al.\u003csup\u003e3\u003c/sup\u003e conducted a factor analysis on the influence of physical activity on medical expenses in the elderly in Hegu area of Sendai Japan, through questionnaire survey; Li Wenchuan\u003csup\u003e4\u003c/sup\u003e conducted an empirical study on the reduction of medical expenditure by physical exercise of the elderly in Shanghai. Lehnert t et al.\u003csup\u003e5\u003c/sup\u003e pointed out that the utilization of medical services is mainly related to physical factors in health conditions, rather than psychological factors. Physical factors mainly refer to chronic disease conditions, physical function conditions and physical activities. Guo Jialiang et al.\u003csup\u003e2\u003c/sup\u003e believe that among the many factors influencing the health and health expenditure of the elderly, physical activity is also becoming one of the main influencing factors. Compared with other factors, physical activity is the most promising factor to be improved through action\u003csup\u003e6\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eBased on the cross-sectional data of China Health and Retirement Longitudinal Study (CHARLS) in 2015, this paper uses the Behavioral Model of Health Services Use (BMHSU) and Tobit model to study the relationship between physical activity and medical expenditure of the elderly, and try to analyze the relationship between the frequency, intensity, duration and form of physical activity and medical expenditure of the elderly.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design.\u003c/strong\u003e When studying the influencing factors of personal medical expenditure, health status is regarded as the most direct influencing factor. Hu Hongwei et al. believe that chronic diseases and self-rated health significantly affect the medical expenditure of the elderly \u003csup\u003e7,8\u003c/sup\u003e. In addition to health status factors, Liu Guoen et al. believe that the income, medical insurance and pension of the elderly will also influence their medical expenditure \u003csup\u003e9-11\u003c/sup\u003e. In addition, education level, marital status, age, gender and urban and rural identity will also influence medical expenditure \u003csup\u003e7,11\u003c/sup\u003e. According to the research on the impact of physical activity on medical expenditure of the elderly, scientific physical activity has significant effect on reducing the incidence of diseases, reducing medical demand and saving medical expenditure\u003csup\u003e12\u003c/sup\u003e. According to the intensity, amount and duration of exercise, Yang Guang \u003csup\u003e3\u003c/sup\u003e divided the amount of physical activity of the elderly over 70 years old in the Hegu area of Sendai Japan into three levels. With the decrease of intensity and amount of exercise, there are significant differences in medical expenditure among the three groups.\u003c/p\u003e\n\u003cp\u003eIn summary, the factors that affect the personal medical expenditure of the elderly in China are relatively complex, involving health status, economic conditions, social security, socio-demographic characteristics, physical activities and many other aspects. Professor Andersen's BMHSU provides a comprehensive and systematic theoretical framework for the research in this field. In this dynamic and interactive relationship model (Figure 1), demographic characteristics affect medical expenditure, and personal health practices affect demographic characteristics. Demographic characteristics include three aspects: need factors, enabling resources and redisposing characteristics \u003csup\u003e13\u003c/sup\u003e. In addition to the medical service utilization behavior, the health behavior in the theoretical model also includes personal health practices, such as diet and exercise \u003csup\u003e14\u003c/sup\u003e. Domestic scholars have systematically introduced the theoretical model \u003csup\u003e13,15\u003c/sup\u003e. Song Lu et al. used the model to explore the influencing factors of rural elderly medical expenditure from the perspective of gender difference \u003csup\u003e16\u003c/sup\u003e; Liu Guoen et al. \u003csup\u003e9\u003c/sup\u003e empirically analyzed the impact of medical security on medical service demand of the elderly's from three dimensions of need, enabling resources and predisposing characteristics based on the theoretical model. Ma Aixia et al. \u003csup\u003e7\u003c/sup\u003e established Tobit model about influencing factors of medical expenditure of the elderly in China based on the model framework. However, no studies have yet incorporated physical activity into the theoretical model.\u003c/p\u003e\n\u003cp\u003eTaking Andersen theoretical model as the research framework, on the premise of controlling predisposing characteristics, enabling resources and need factors, this paper will conduct empirical research on the correlation between physical activity variables in personal health practicess and medical expenditure, promote the further improvement of the theoretical model, and provide reference for the development of related research in China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData source.\u003c/strong\u003e The data used in this paper are the cross-sectional data of China Health and Retirement Longitudinal Study (CHARLS) of National School of Development of Peking University in 2015. The sample covers 21000 respondents from 12400 families. The survey subjects are mainly the micro data of families and individuals aged 45 and above in China and the survey contents include basic information, health status and function, medical care and insurance, work, retirement and pension, of which physical activity variable is a secondary sampling survey. After excluding the samples under 60 years old and lack of relevant variables and secondary sampling, 4093 samples are eventually used in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelection of variables.\u003c/strong\u003e The per capita medical expenditure of the elderly is the dependent variable of this study, which is the sum of the monthly outpatient expenditure and the annual hospitalization expenditure in the questionnaire \u003csup\u003e7,17\u003c/sup\u003e, including the reimbursement of medical insurance and the part of individual self-payment.\u003c/p\u003e\n\u003cp\u003eAccording to BMHSU, fifteen variables including need factors, enabling resources, predisposing characteristics, personal health practices and the use of medical services are selected as independent variable and control variable (Table 1), of which personal health practices mainly select sports dimension, including four levels of physical activity. Physical activity refers to any physical activity that results in energy consumption caused by skeletal muscle contraction, which is composed of four types of physical activities: occupational, traffic, housework and leisure \u003csup\u003e18,19\u003c/sup\u003e. Intensity, duration weekly and duration each time are used as index to measure physical activity \u003csup\u003e20\u003c/sup\u003e. The impact of physical activity on health depends on the way, intensity, duration, frequency and total amount of physical activity \u003csup\u003e21\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eIn this study, the selection of independent variable \u0026mdash;\u0026mdash;four levels of physical activity is derived from the question of \"physical activity\" in the 2015 CHARLS questionnaire: \"How long do you usually take in these activities (including high intensity, medium intensity and walking) in a week?\". According to WHO physical activity guidelines for the elderly\u003csup\u003e25\u003c/sup\u003e, Chinese adult physical activity guidelines of at least 30 minutes per day, Chinese Ministry of Health's proposal of \"ten thousand steps per day\", and the related research on physical activity amount, the independent variables are divided into four levels \u003csup\u003e3\u003c/sup\u003e, and the level 4 physical activity group includes: high intensity exercise (more than 75 minutes per week, no less than 10 minutes each time), moderate intensity exercise (more than 150 minutes per week, no less than 10 minutes each time), and walking (210 minutes a week, no less than 10 minutes each time); The level 3 physical activity group includes: no high intensity exercise, moderate intensity exercise (more than 150 minutes per week, not less than 10 minutes each time), walking (210 minutes a week, not less than 10 minutes each time); The level 2 physical activity group includes: no high and moderate intensity exercise, walking (210 minutes a week, not less than 10 minutes each time); The level 1 physical activity group includes: the elderly who doesn\u0026rsquo;t meet the above three levels of intensity. The level 1 physical activity group doesn\u0026rsquo;t meet the physical activity, the other three groups meet the physical activity.\u003c/p\u003e\u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-bottom:8.0pt;text-align:center;line-height:108%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 15px; line-height: 108%; font-family: Calibri, sans-serif; color: black;\"\u003eTable 1\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eDefinition of variables\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cdiv align=\"center\" style=\"margin:0in;font-size:16px;font-family:SimSun;\"\u003e\n \u003ctable style=\"width: 3.8e+2pt;border-collapse:collapse;border:none;\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92.15pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 14.85pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMeasured content\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 14.85pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eVariables\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 14.85pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMeasured index\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eNeed factors\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eSelf-rated health\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eExcellent=4，Good=3，Normal=2，Bad=1，Very bad=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eDisability\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eYes=1，No=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eChronic disease\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eYes=1，No=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eEnabling resources\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMedical insurance\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eYes=1，No=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePension\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eYes=1，No=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePersonal income\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAll income in last year (continuous variable)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePredisposing characteristics\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eGender\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMale=1，Female=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAge\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 16.35pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e60-69=0, 70-79=1, 80 and above=2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eEducation level\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:left;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eIlliterate=0, Primary school (including private school)=1, Middle school=2, High school and above=3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMarital status\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMarried and cohabiting with spouse =1, Others=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eCity or rural\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eCity=1, Rural=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92.15pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePersonal health practices\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4 levels physical activity\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border: none;padding: 0in 5.4pt;height: 19.05pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 4 PA group=3, Level 3 PA group=2, Level 2 PA group=1, Level 1 PA group=0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 92.15pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 18.15pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePer capita medical expenditure\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 18.15pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMonthly outpatient expenditure and annual inpatient expenditure\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 198.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 18.15pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif; font-size: 15px;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAnnual per capita medical expenditure (continuous variable)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003c/table\u003e\n\u003c/div\u003e\u003cbr\u003e\u003cp\u003e\u003cstrong\u003eTobit Model.\u003c/strong\u003e Based on the data characteristics and the application study of Tobit model by demography related scholars \u003csup\u003e7,22,23\u003c/sup\u003e, this paper will establish Tobit model of influencing factors of the elderly medical expenditure.\u003c/p\u003e\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/58653_1b1c6aeb34a62c68/58653_custom_files/img1609241146.jpg\"\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u003c/strong\u003e For all experiments on humans, we confirm that all methods were carried out in accordance with relevant guidelines and regulations. The CHARLS received ethics approval from both a national government administration and an institutional review board or ethics committee. Only adolescents who provided written/verbal consent participated. As the current study used retrospective publicly available data, we did not require ethics approval from any Institutional Ethics Review Committee for this secondary analysis.\u003c/p\u003e\n\u003cp\u003eThe CHALRS questionnaire refers to international experience, including the American Health and Retirement Survey (HRS), the British Elderly Tracking Survey (ELSA), and the European Health, Old Age and Retirement Survey (SHARE), etc. Multi-stage sampling is adopted in the project, and PPS sampling method is adopted in both county/district and village sampling stages. The response rate and the quality of CHARLS data are among the best in similar projects in the world, and the data has been widely used and recognized in academia.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eComparison of physical activities of the elderly with different characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data shows that there are significant differences in medical expenditure, gender, education level, marital status, pension, self-rated health status, and whether there is disability or not (Table 2).\u003c/p\u003e\n\u003cp\u003eThe medical expenditure and physical activity of the elderly who meet the physical activity shows a negative correlation trend; the proportion of men in level 4 physical activity group is higher than that in the other three groups; the education level of the elderly who meet the physical activity amount is higher than that in the elderly with insufficient physical activity; the self-rated health status of the elderly who meet the physical activity amount is more positive than that in the elderly who doesn\u0026rsquo;t meet the physical activity.\u003c/p\u003e\n\u003cp\u003eFor the elderly who don\u0026rsquo;t meet the physical activity amount, the majority of them are women, whose age are higher than the average age, which is 70.52 years old. Their education levels are mainly below primary school, and cohabiting with spouse are also below the average level. The proportion of buying medical insurance and insurance is relatively low, and the personal income is lower than the average level. The self-rated health status is relatively negative, and the proportion of disabled people is more than a half. According to the physical activity of the disabled elderly, 80.41% of them meet the physical activity, and the number of persons participating in the second, third and fourth level physical activity is distributed more evenly, which indicates that most of the disabled elderly have certain demand for physical activity. For the elderly patients with chronic diseases, 84.48% of the elderly meet the physical activity level, and the number of persons participating in the second, third and fourth level of physical activity is distributed more evenly. Among the four groups of elderly physical activity, there are no statistically significant differences in the comparison of physical intensity in the five indicators of age, urban and rural household registration, personal income, medical insurance and whether there is chronic disease.\u003c/p\u003e\u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-bottom:8.0pt;text-align:center;text-indent:22.1pt;line-height:108%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 15px; line-height: 108%; font-family: Calibri, sans-serif; color: black;\"\u003eTable 2\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eGroup difference of four levels of physical activity in the elderly\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cdiv align=\"center\" style=\"margin:0in;font-size:16px;font-family:SimSun;\"\u003e\n \u003ctable style=\"width: 129%;border: none;border-collapse:collapse;\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 10.54%;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMeasured content\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 18.4%;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eVariables\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 60.54%;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAverage value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 10.52%;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eF/X\u003csup\u003e2\u003c/sup\u003e value\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 46.06%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMeet physical activity amount\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.48%;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eDo not meet physical activity amount\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.48%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 4 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 3 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 2 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:14.48%;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 1 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 10.54%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.4%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eNumbers（N/%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:right;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1205（29.44）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:right;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1088（26.58）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:right;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1174（28.68）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:right;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e626（15.29）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;border: none;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:right;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 10.54%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eIndependent variable\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAnnual medical expenditure\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e9061\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e23479\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e26165\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-indent:27.5pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e22509\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e12.40\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 10.54%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePredisposing characteristics\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMale（%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e57.43%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e43.47%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e49.40%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e45.85%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e16.65\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eAge\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e66.25\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e67.38\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e69.38\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e70.52\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-right:5.25pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e85.40\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eEducation level\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1.00\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1.15\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1.12\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.86\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e19.34\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMarried with spouse\u0026nbsp;（%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e83.98\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e77．30\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e76.40\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e72.04\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e13.55\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eUrban residence\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.12\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.33\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.34\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.21\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e70.62\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 10.54%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eEnabling resources\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eMedical insurance（%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e92.45\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e94.67\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e92.08\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e87.22\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e10.29\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePension（%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e74.19\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e75.92\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e70.70\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e69.65\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-indent:5.5pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4.10\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePersonal income（元）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2061.87\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1437.71\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1426.50\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1344.10\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-indent:5.5pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4.96\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 10.54%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eNeed factors\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eSelf-rated health\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2.18\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2.16\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2.08\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1.86\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e20.11\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eDisability(%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e39.17\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e34.65\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e41.65\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e52.08\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e17.43\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.4%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:justify;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eChronic disease（%）\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e72.86\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.78%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e74.45\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.8%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e71.81\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.48%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e74.28\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.52%;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;height: 13pt;vertical-align: top;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-indent:5.5pt;line-height:108%;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif; font-size: 15px;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.82\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003c/table\u003e\n\u003c/div\u003e\u003cp\u003e\u003cspan style=\"font-size: 13px; font-family: Calibri, sans-serif; color: black;\"\u003eNote: ***: P\u0026lt;001; **: P\u0026lt;0.05; *: P\u0026lt;0.1\u003c/span\u003e\u003c/p\u003e\n\u003cbr\u003e\u003cp\u003e\u003cstrong\u003eResults of Tobit model\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to model 1, physical activity of the elderly will significantly influence the medical expenditure of the elderly in China. The lower the physical activity, the higher the medical expenditure of the elderly (Table 3). In model 2, predisposing characteristics are included. The results show that all levels of physical activity still had significant impact on medical expenditure of the elderly in model 2. In model 3, the enabling resources are also included in the model to analyze the influence of various dimensional variables on medical expenditure of the elderly when they access to medical services and resources. The results show that personal income will significantly influence the medical expenditure of the elderly, which is consistent with that personal income is the most important factor in relevant research \u003csup\u003e23\u003c/sup\u003e; the medical expenditure of the elderly with income is 1.03 times as much as that of the non-income, while physical activity, education level, marital status and urban or rural identity still have a significant impact on the medical expenditure of the elderly. Compared with the elderly with the level 1 physical activity, the elderly who participate in level 4, level 3 and level 2 physical activity will reduce medical expenditure by 15134.92 yuan, 10828.5 yuan and 3903.13 yuan respectively. Participating in physical activities will reduce the medical expenditure by 5298.67 yuan.\u003c/p\u003e\n\u003cp\u003eIn model 4, the need factors were included in the post analysis, and the self-rated health status of the elderly significantly influences the medical expenditure of the elderly in China. In addition, disease is the most direct influencing factor, and the average annual medical expenditure of elderly patients with chronic diseases is 2965.51 yuan, while that of the elderly without chronic diseases is only 1637.52 yuan. Whether or not suffering from disability has no significant impact on the medical expenditure of the elderly. It is worth noting that education level, marital status, personal income, self-rated health status, whether suffering from chronic diseases still have significant impact on medical expenditure of the elderly in model 4, but physical activity has no significant impact on medical expenditure of the elderly. In the related research on the influencing factors of medical expenditure of the elderly, the two-categorical variable of physical exercise\u0026mdash;\u0026mdash;\"yes or no\" is included in the model study, and the result is also not significant\u003csup\u003e 24\u003c/sup\u003e.\u003c/p\u003e\u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-bottom:8.0pt;text-align:center;line-height:108%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 15px; line-height: 108%; font-family: Calibri, sans-serif; color: black;\"\u003eTable 3\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;Tobit model of medical expenditure of the elderly in China\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cdiv align=\"center\" style=\"margin:0in;font-size:16px;font-family:SimSun;\"\u003e\n \u003ctable style=\"border: none;border-collapse:collapse;\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:25.25pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eVariables\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:25.25pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eModel 1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:25.25pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eModel 2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:25.25pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eModel 3\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:solid windowtext 1.0pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0in 5.4pt 0in 5.4pt;height:25.25pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eModel 4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border:none;padding:0in 5.4pt 0in 5.4pt;height:22.15pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eIndependent variable\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;padding:0in 5.4pt 0in 5.4pt;height:22.15pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;padding:0in 5.4pt 0in 5.4pt;height:22.15pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;padding:0in 5.4pt 0in 5.4pt;height:22.15pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;padding:0in 5.4pt 0in 5.4pt;height:22.15pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePhysical activity\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-4865.68\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-5555.37\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-5298.67\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-2756.12\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 2 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-4368.31\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-4269.57\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-3903.13\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e1894.832\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 3 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-10905.07\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-11393.51\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-10828.5\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-3077.957\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLevel 4 PA\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-14055.53\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-15947.47\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-15134.92\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-6550.634\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePredisposing characteristics\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:14.05pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; 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color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-7757.82\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-8164.82\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePension\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:5.5pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2400.06\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2339.13\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003ePersonal income\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-1308.75\u003csup\u003e**\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-883.20\u003csup\u003e*\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eNeed factors\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eSelf-rated health status\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e-25757.08\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eDisability\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e2395.01\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eChronic disease\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e14458.73\u003csup\u003e***\u003c/sup\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:3.3pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eN\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:3.3pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4093\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:3.3pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4093\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:3.3pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4093\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:3.3pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e4093\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;text-indent:22.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eLogarithm Likelihood function\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; 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color: black;\"\u003e0.0043\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.0037\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.0017\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.0pt;\"\u003e\n \u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;text-align:center;line-height:108%;\"\u003e\u003cspan style=\"font-size: 15px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003e0.0000\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-bottom:8.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 13px;\"\u003e\u003cspan style=\"font-family: Calibri, sans-serif;\"\u003e\u003cspan style=\"line-height: 108%; color: black;\"\u003eNote: ***: P\u0026lt;001; **: P\u0026lt;0.05; *: P\u0026lt;0.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;font-size:16px;font-family:SimSun;margin-bottom:8.0pt;line-height:108%;\"\u003e\u003cspan style=\"font-size: 13px; line-height: 108%; font-family: Calibri, sans-serif; color: black;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn the whole life course, physical activity is closely related to health. A large number of cross-sectional studies and longitudinal studies have shown that the relative risk of limited activity function is reduced by 50% among people who regularly participate in at least moderate intensity of physical activity. For the elderly, physical activity can reduce anxiety and depression and improve self-confidence by maintaining muscle strength and cognitive ability. Randomized controlled trials show that physical activity can increase social participation, maintain social networks and intergenerational connectivity. In addition, a large number of literature shows that physical activity has an impact on health status, but this study concluded that due to the impact of health, the influence of physical activity on medical expenditure is significant or insignificant.\u003c/p\u003e\n\u003cp\u003eIn Tobit model 4, after adding the need factors, there are statistical effects on influence of health and whether suffering from chronic diseases on the elderly medical expenditure, which also proves the direct impact of health on medical expenditure. The self-rated health status of the elderly will significantly influence the medical expenditure of the elderly in China. The more negative the self-rated health status is, the higher the medical expenditure is. Maybe when the elderly self-rated health status is poor, outpatient treatment is frequent\u003csup\u003e26\u003c/sup\u003e. In addition, disease is the most direct influencing factor. The prevalence of chronic diseases in the elderly in China is relatively high, with an average of 1.68 chronic diseases, of which 73.21% suffer from one or more chronic diseases. Elderly patients with chronic diseases have a long and large demand for medical care. In addition, once the chronic diseases recur, the treatment cost is very expensive\u003csup\u003e23\u003c/sup\u003e. It also further shows that the average annual medical expenditure of the elderly patients with chronic diseases is higher than that of the healthy elderly. Whether suffering from disabilities has no significant impact on the medical expenditure of the elderly, which is the same as Ma Aixia's analysis. The reason may be that most disabilities, such as physical disability, deafness and blindness, do not need continuous medication or hospitalization, so the impact on medical expenditure is limited \u003csup\u003e6\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe study also finds that the higher the education level is, the higher the medical expenditure is. The medical expenditure of the elderly with diploma of primary school, middle school, high school and above are 1.01, 1.34 and 1.77 times of that of illiterate people respectively and higher education level increases the ability of the elderly to use medical services \u003csup\u003e27\u003c/sup\u003e, which is the same with Liu Guoen et al.\u0026rsquo;s study result that income has a significant impact on medical expenditure, and the medical expenditure of high-income population is significantly higher than that of the low-income population \u003csup\u003e10\u003c/sup\u003e. The higher the income level of the elderly is, the more attention they pay to their health status, so the medical expenditure is more \u003csup\u003e23\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eAccording to the results of one-way ANOVA of physical activity of the elderly with different characteristics, the medical expenditure and physical activity of the elderly who meet the amount of physical activity show a negative correlation. At the same time, Tobit model 1 shows that physical activity has a significant impact on medical expenditure. The medical expenditure of elderly people who participate in high-intensity or moderate intensity exercise and walking exercise is far lower than those who only participate in walking exercise and who walk for 210 minutes or more a week, that is there is a difference medical expenditure between the elderly people who participate in walking only and those who participate in middle and high intensity of physical exercise. By reviewing the literature in sports about the impact of physical activity on medical expenditure in China, it is found that the research in this field is still in its infancy. Yang Guang \u003csup\u003e3\u003c/sup\u003e and Yang Wenchuan \u003csup\u003e4\u003c/sup\u003e et al. found that physical activity played an important role in restraining the growth of medical expenditure. And the related foreign research also confirmed this result. On one hand, insufficient physical activity will influence medical expenditure. Ding et al. \u003csup\u003e28\u003c/sup\u003e estimated that the global lack of physical activity in 2013 had led to an increase of about 53.8 billion US dollars in global health care expenditure. On the other hand, regular physical activity is helpful to relieve the pressure of medical expenditure. Ackerman et al. \u003csup\u003e29\u003c/sup\u003e used a retrospective cohort study and found that the average annual medical expenditure of the elderly over 65 years old who participated in community exercise programs in the past three years was far lower than that of those who did not regularly participate in physical exercise. However, there is a lack of research on the difference of medical expenditure between walking and middle or high-intensity exercise.\u003c/p\u003e\n\u003cp\u003eIn addition, because predisposing characteristics will not directly influence personal medical expenditure, but indirectly play a role through influencing enabling resources and need factors \u003csup\u003e8\u003c/sup\u003e, as the basis in building model, the predisposing characteristics are analyzed firstly and included the direct influencing factors\u0026mdash;\u0026mdash;need factors in this paper. In this study, because the occurrence of diseases or the decline in health status are the prerequisites and direct influencing factors for individuals to use medical services \u003csup\u003e8\u003c/sup\u003e, therefore, with the addition of need factors in model 4, the impact of physical activity changes is significant to insignificant. To a certain extent, physical activity will not directly influence medical expenditure, but may influence that by chronic diseases and self-rated health status, which confirms the exploration of the dynamic relationship between health behavior and demographic characteristics by BMHSU model from the side \u003csup\u003e14\u003c/sup\u003e. Through many quantitative empirical studies, scholars at home and abroad have shown that there is a certain correlation between physical activity and medical expenditure of the elderly, but they have not explained the influencing path at the same time. At present, some studies take health-related variables as mediation factors for path analysis. A public health survey in Sweden studied the mediation role of self-rated health between physical activity and medical service utilization through path analysis \u003csup\u003e30\u003c/sup\u003e. The influence of physical activity on medical expenditure is a long-term effect, so it is suggested that the elderly should be encouraged to improve their need factors through physical activity, thus affecting medical expenditure. However, for its mechanism, it is suggested to use path analysis to explore, which can be further demonstrated in future research.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from National School of Development, Peking University. Restrictions apply to the availability of these data, which were used under license for this study. Data are available at \u003ca href=\"http://charls.pku.edu.cn/pages/data/111/zh-cn.html\"\u003ehttp://charls.pku.edu.cn/pages/data/111/zh-cn.html\u003c/a\u003e with the permission of Peking University.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge National School of Development of Peking University and China Center for Economic Research Institute of Social Science Survey of Peking University for providing China Health and Retirement Longitudinal Study (CHARLS) data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eC. Hong conceived the design and performed statistical analysis and F. Wu performed the figure generation. All authors reviewed the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNational Bureau of Statistics.China Statistical Yearbook 2019.Beijing:China Statistical Publishing House, 2019\u003c/li\u003e\n\u003cli\u003eGuo Jialiang, Xiang Chun \u0026amp; Yu Hongjun, et al. Study on the Economic Benefits of Physical Activity for the Urban Chinese Elderly Based on Interval Regression.China Sport Science and Technology, 54, 31-38(2018),\u003c/li\u003e\n\u003cli\u003eYang Guang, Guo Yulian \u0026amp; Bai Cuijin, et al. The effect of physical activity on medical expenses for the elderly. 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Prevalence of Comorbidity among the Elderly and Its Impact on Healthcare Expenditure in China.Chinese General Practice, 22,4166-4172(2019).\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. \"World Report on Aging and Health\". Switzerland: World Health Organization, 68-69(2016).\u003c/li\u003e\n\u003cli\u003e[26]Chen Liqiang \u0026amp; Ning Manxiu.The effect and policy recommendations of informal care on medical expenditure of the elderly.China Health Policy Research, 9,56-61(2016).\u003c/li\u003e\n\u003cli\u003eGeng Dewei.Research on the Income, Consumption and Savings of the Elderly in China.Beijing: Graduate School of Chinese Academy of Social Sciences,(2012).\u003c/li\u003e\n\u003cli\u003eDing Ding, Kenny D Lawson \u0026amp; Tracy L Kolbe-Alexander, et al.The economic burden of physical inactivity: a global analysis of major non-communicable diseases.The Lancet,388,1311-1324(2016).\u003c/li\u003e\n\u003cli\u003eAckermann R T, Cheadle A \u0026amp; Sandhu N, et al. Community exercise program use and changes in healthcare costs for older adults.American Journal of Preventive Medicine, 25,232-237(2003).\u003c/li\u003e\n\u003cli\u003e\u003ca href=\"https://www.researchgate.net/scientific-contributions/Patricia-Rocca-2081081978\"\u003ePatricia Rocca\u003c/a\u003e,\u003ca href=\"https://www.researchgate.net/profile/Anders_Beckman\"\u003eAnders Beckman\u003c/a\u003e,\u003ca href=\"https://www.researchgate.net/profile/Eva_Hansson\"\u003eEva Ekvall Hansson\u003c/a\u003e \u0026amp;\u003ca href=\"https://www.researchgate.net/scientific-contributions/Henrik-Ohlsson-38564419\"\u003eHenrik Ohlsson\u003c/a\u003e.Is the association between physical activity and healthcare utilization affected by self-rated health and socio-economic factors.Bmc Public Health,15,737(2015).\u003c/li\u003e\n\u003cli\u003ePeking University China Social Science Survey Center, 2018, China Health and Retirement Longitudinal Study (2015), http://opendata.pku.edu.cn/, Peking University Open Research Data Platform, V1\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"aging, elderly, medical burden","lastPublishedDoi":"10.21203/rs.3.rs-124062/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-124062/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Becoming more and more serious of such problems as acceleration of aging and high medical burden of the elderly in China, research on the influence of physical activity on medical expenditure in the elderly has attracted a lot of attention. In this work, Tobit model is established based on the data from China Health and Retirement Longitudinal Study in 2015 and Behavioral Model of Health Services Use theoretical framework. Compared with the inactive elderly, the medical expenditure of the elderly who participate in the level 4, 3, 2 physical activity decreasing step by step. After involving need factors in the model, the influence of physical activity on medical expenditure varies from significant to insignificant. The medical expenditure of the elderly who meet the physical activity amount is negatively correlated with the physical activity amount, and is lower than that of the elderly who don’t meet physical activity amount. Physical activity will not directly affect medical expenditure, but will affect medical expenditure through chronic diseases and self-rated health status. Our results provide theoretical analysis and empirical test for enriching physical activity guidelines and Behavioral Model of Health Services Use in the elderly in China.","manuscriptTitle":"Research on influence of physical activity on medical expenditure in the elderly in China—Based on CHARLS in 2015","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-12-29 15:29:44","doi":"10.21203/rs.3.rs-124062/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"63d153f8-7c63-4d42-b349-d360a32d04c5","owner":[],"postedDate":"December 29th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":1652582,"name":"Health Economics \u0026 Outcomes Research"},{"id":1652583,"name":"Health Policy"}],"tags":[],"updatedAt":"2021-05-27T05:29:14+00:00","versionOfRecord":[],"versionCreatedAt":"2020-12-29 15:29:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-124062","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-124062","identity":"rs-124062","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}