RESEARCH ARTICLE Is preventive care utilization associated with lower outpatient and inpatient health-care expenses among Chinese older adults? A longitudinal analysis Yen-Han Lee 1 | Yen-Chang Chang 2 | Mack Shelley 3,4 1 Department of Applied Health Sciences, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA 2 Center for General Education, National Tsing Hua University, Hsinchu City, Taiwan 3 Department of Political Science, Iowa State University, Ames Iowa, USA 4 Department of Statistics, Iowa State University, Ames Iowa, USA Correspondence Yen-Han Lee, Department of Applied Health Sciences, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405. Email: yil5050@bu.edu Summary Background: China has made major improvements to its health-care system since the early 21st century. However, the effectiveness of preventive care utilization on health- care costs remains limited. This study seeks to understand the effect of preventive care utilization on outpatient and inpatient health-care expenses. Methods: With the use of the Chinese Longitudinal Healthy Longevity Survey with older adults who were 65 years old or above (n = 2828), Tobit regression models were estimated to examine the association of preventive care utilization and expenses with medical treatments. Preventive care utilization in the previous wave was used to predict health-care costs for treatments in the next wave. Propensity score matching was used to reduce potentially confounding factors. Findings: Results indicated that preventive care utilization was positively associated with outpatient health care among Chinese older adults (β = 231.8, standard error [SE] = 71.5, P < .01). The association between preventive care utilization and inpatient health-care expenses was not significant. Conclusions: Despite the results from previous studies suggesting that preventive care utilization can help reduce health-care expenses, this study does not support such a claim among Chinese older adults. The long-term association between preventive care utilization and health-care expenses for treatment should be studied further. Received: 3 October 2019 Revised: 14 October 2019 Accepted: 15 October 2019 DOI: 10.1002/hpm.2945 142 © 2019 John Wiley & Sons, Ltd. Int J Health Plann Mgmt. 2020;35:e142– 155. wileyonlinelibrary.com/journal/hpm e e