Abstract: Population ageing is one of the greatest challenges for the human society in the 21st century, impacting social and economic development of all the countries in the world. This paper focuses on health and medical expenditure of the elderly in the context of rapid population ageing in China. Based on the Health Transition and Two Part Models, it analyzes the fitted value of the transition probabilities and medical expenditure of disabled elderly. On the basis of future elderly population in China, it predicts the size of Chinese elderly with various health statuses and the trend of medical expenditure. The study finds that the elderly with mild disability have better health maintenance probability and better health improvement probability, while the elderly with moderate and severe disabilities have higher risk of becoming poor health status or death. Along with the increase of the elderly, the size of disabled elderly population in China is expanding, which exerts great pressure on medical services and medical expenditure.

Keywords: Disabled Elderly, Health Transition, Medical Expenditure, Ageing Population, Elderly Health

摘要： 21世纪的人类社会是人口老龄化的社会，日益渐重的老龄化程度对世界各国的社会经济发展都有重要的影响，对绝大多数国家来说，人口老龄化都是严峻的挑战。以人口老龄化的快速发展为背景，围绕老年人口健康与医疗支出这一主线，基于健康转移模型和两部分模型，定量分析老年人失能状况的转移概率和医疗支出的拟合值，并在未来中国老年人口规模变动的基础上，预测各种健康状态下老年人口的规模和医疗支出趋势。研究发现：轻度失能老人拥有较好的健康维持概率，健康好转概率相对较高，中度和重度失能老年人健康状态转差或死亡的概率较高；随着老年人口基数的增加，到2035年，不同程度失能老年人的规模将会逐渐扩大，这对医疗服务形成巨大压力，医疗支出显著增加。

关键词: 失能老年人口, 健康转移, 医疗支出, 人口老龄化, 老年健康