scholarly journals The Morbidity Costs of Air Pollution through the Lens of Health Spending in China

2021 ◽  
Author(s):  
Xin Zhang ◽  
Xun Zhang ◽  
Xi Chen ◽  
Yuehua Liu ◽  
Xintong Zhao
Keyword(s):  
Health Spending ◽  
Healthcare Spending ◽  
Medical Expenditures ◽  
Fine Particulates ◽  
Thermal Inversion ◽  
Individual Level ◽  
Age Cohorts ◽  
Basic Medical Insurance ◽  
Basic Medical ◽  
Value Of Health

This study offers one of the first causal evidence on the morbidity costs of fine particulates (PM2.5) for all age cohorts in a developing country, using individual-level healthcare spending data from the basic medical insurance program in Wuhan, China. Our instrumental variable (IV) approach uses thermal inversion to address potential endogeneity in PM2.5 concentrations and shows that PM2.5 imposes a significant impact on medical expenditures. The IV estimate suggests that a 10 μg/m3 reduction in monthly average PM2.5 leads to a 2.79% decrease in the value of health spending and a 0.70% decline in the number of transactions in pharmacies and health facilities. The effect is more salient for males, children, and older adults. Moreover, our estimates provide a lower bound of people's willingness-to-pay, which amounts to CNY 51.85 (or USD 8.38) per capita per year for a 10 μg/m3 reduction in PM2.5.

scholarly journals The effect of different classification of hospitals on medical expenditure from perspective of classification of hospitals framework: evidence from China

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Lele Li ◽  
Tiantian Du ◽  
Yanping Hu
Keyword(s):  
Diagnostic Testing ◽  
Healthcare Services ◽  
Medical Expenditures ◽  
Medical Expenditure ◽  
Basic Medical Insurance ◽  
The Government ◽  
The Impact ◽  
Average Expenditure ◽  
Basic Medical

Abstract Background Different classification of hospitals (COH) have an important impact on medical expenditures in China. The objective of this study is to examine the impact of COH on medical expenditures with the hope of providing insights into appropriate care and resource allocation. Methods From the perspective of COH framework, using the Urban Employee Basic Medical Insurance (UEBMI) data of Chengdu City from 2011 to 2015, with sample size of 488,623 hospitalized patients, our study empirically analyzed the effect of COH on medical expenditure by multivariate regression modeling. Results The average medical expenditure was 5468.86 Yuan (CNY), the average expenditure of drug, diagnostic testing, medical consumables, nursing care, bed, surgery and blood expenditures were 1980.06 Yuan (CNY), 1536.27 Yuan (CNY), 500.01 Yuan (CNY), 166.23 Yuan (CNY), 221.98 Yuan (CNY), 983.18 Yuan (CNY) and 1733.21 Yuan (CNY) respectively. Patients included in the analysis were mainly elderly, with an average age of 86.65 years old. Female and male gender were split evenly. The influence of COH on total medical expenditures was significantly negative (p < 0.001). The reimbursement ratio of UEBMI had a significantly positive (p < 0.001) effect on various types of medical expenditures, indicating that the higher the reimbursement ratio was, the higher the medical expenditures would be. Conclusions COH influenced medical expenditures significantly. In consideration of reducing medical expenditures, the government should not only start from the supply side of healthcare services, but also focus on addressing the demand side.

scholarly journals Direct medical costs of hospitalisations for mental disorders in Shanghai, China: a time series study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e015652 ◽  
Author(s):  
Wenming Chen ◽  
Shengnan Wang ◽  
Qi Wang ◽  
Weibing Wang
Keyword(s):  
Time Series ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Hospital Admissions ◽  
Health Expenditures ◽  
Medical Insurance ◽  
Medical Costs ◽  
Medical Expenditures ◽  
Basic Medical Insurance ◽  
Basic Medical

ObjectivesTo provide cost burden estimates and long-term trend forecast of mental disorders that need hospitalisations in Shanghai, China.DesignDaily hospital admissions and medical expenditures for mental disorder hospitalisations between 1 January 2011 and 31 December 2015 were used for analysis. Yearly total health expenditures and expenditures per hospital admission for different populations, as well as per-admission-per-year medical costs of each service for mental disorder hospitalisations, were estimated through data from 2015. We also established time series analyses to determine the long-time trend of total direct medical expenditures for mental disorders and forecasted expenditures until 31 December 2030.SettingShanghai, China.ParticipantsDaily hospital admissions for mental disorders of registered residents living in all 16 districts of Shanghai, who participated in workers’ basic medical insurance or the urban residents’ basic medical insurance (n=60 306).ResultsFrom 2011 to 2015, there were increased yearly trends for both hospitalisations (from 10 919 to 14 054) and total costs (from US$23.56 to 42.13 million per year in 2015 currency) in Shanghai. Cost per mental disorder hospitalisation in 2015 averaged US$2998.01. Most direct medical costs were spent on medical supplies. By the end of 2030, the average cost per admission per month for mental disorders was estimated to be US$7394.17 (95% CI US$6782.24 to 8006.10) for mental disorders, and the total health expenditure for mental disorders would reach over US$100.52 million (95% CI US$92.20 to 108.83 million) without additional government interventions.ConclusionsThese findings suggest total health expenditures for mental disorders in Shanghai will be higher in the future. Effective measures should be taken to reduce the rapid growth of the economic burden of mental disorders.

scholarly journals The Effect of Health Shock and Basic Medical Insurance on Family Educational Investment for Children in China

2021 ◽  
Vol 18 (10) ◽  
pp. 5242
Author(s):  
Pu Liao ◽  
Zhihong Dou ◽  
Xingxing Guo
Keyword(s):  
Negative Impact ◽  
Medical Insurance ◽  
Generation Model ◽  
Two Phase ◽  
Parental Health ◽  
Health Shock ◽  
Basic Medical Insurance ◽  
Child Education ◽  
The Impact ◽  
Basic Medical

This paper explores the role of basic medical insurance in protecting family investment in child education. First, this paper establishes a two-phase overlapping generation model to theoretically analyse the impact of basic medical insurance on investment in child education under the influence of the impact of parental health. The results show that health shock reduces parental investment in child education, and medical insurance significantly alleviates the negative impact of parental health shock on investment in child education. Furthermore, this paper establishes a two-way fixed effect regression model based on the data of China Family Panel Studies (CFPS) in 2014 and 2016 to empirically test the above results. The results showed that parental health shocks negatively affect investment in child education, and paternal health shock has a more significant impact than maternal health shock. However, medical insurance significantly reduces this negative impact, provides security in investment in child education, and promotes the improvement of human capital.

scholarly journals Comorbidity in lung cancer patients and its association with hospital readmission and fatality in China

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Zhu ◽  
Ruoxi Ding ◽  
Yong Ma ◽  
Zhishui Chen ◽  
Xuefeng Shi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Hospital Readmission ◽  
Medical Insurance ◽  
Hospital Death ◽  
Comorbid Condition ◽  
Lung Cancer Patients ◽  
Basic Medical Insurance ◽  
Increased Risk ◽  
Basic Medical

Abstract Background Comorbidity has been established as one of the important predictors of poor prognosis in lung cancer. In this study, we analyzed the prevalence of main comorbidities and its association with hospital readmission and fatality for lung cancer patients in China. Methods The analyses are based on China Urban Employees’ Basic Medical insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) claims database and Hospital Information System (HIS) Database in the Beijing University Cancer Hospital in 2013–2016. We use Elixhauser Comorbidity Index to identify main types of comorbidities. Results Among 10,175 lung cancer patients, 32.2% had at least one comorbid condition, and the proportion of patients with one, two, and three or more comorbidities was 21.7, 8.3 and 2.2%, respectively. The most prevalent comorbidities identified were other malignancy (7.5%), hypertension (5.4%), pulmonary disease (3.7%), diabetes mellitus (2.5%), cardiovascular disease (2.4%) and liver disease (2.3%). The predicted probability of having comorbidity and the predicted number of comorbidities was higher for middle elderly age groups, and then decreased among patients older than 85 years. Comorbidity was positively associated with increased risk of 31-days readmission and in-hospital death. Conclusion Our study is the first to provide an overview of comorbidity among lung cancer patients in China, underlines the necessity of incorporating comorbidity in the design of screening, treatment and management of lung cancer patients in China.

scholarly journals The influence of medical insurance and social security cards on the floating population's settlement intention

2020 ◽  
Author(s):  
Yulin Li ◽  
Lingling Huang ◽  
Li Xiang ◽  
dongmei dou
Keyword(s):  
Social Security ◽  
Social Integration ◽  
Indirect Effect ◽  
Structural Equation ◽  
Medical Insurance ◽  
Floating Population ◽  
Dynamic Monitoring ◽  
Basic Medical Insurance ◽  
The Government ◽  
Basic Medical

Abstract Background There are many studies on the influencing factors of floating population's intention to settle down. Medical insurance and social security cards have an important guarantee for the floating population to live a stable life in the current residence, but there are limited studies focused on the influence of medical insurance and social security cards on their settlement intention. Therefore, the purpose of this paper is to study the influence of medical insurance and social security card on the settlement intention of floating population, so as to create better living and working conditions for floating population and improve their happiness in their current place of residence. Methods Based on the survey data of China's floating population dynamic monitoring in 2017, we explored the influence of medical insurance (urban employee basic medical insurance) and social security cards on the floating population's settlement intention with binary logistic regression and structural equation model. Additionally, this study was also to examine the comprehensive causal relationship, with social integration as the mediator variable. Results The floating population's settlement intention on participating in urban employee basic medical insurance is 23.2 percent higher than those who did not participate. Whether to apply for personal social security cards is related to the settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention are positive values, and the Z values ​​of the overall effect, indirect effect, and direct effect are all greater than 1.96, and the confidence interval of the indirect effect does not include 0. The article found that this model is a partial intermediary, with an intermediary ratio of 10.66 percent. Conclusions The article highlights the important impact of urban workers' medical insurance and individual social security cards on the floating population. The results of this study may provide some reference for the government to formulate relevant policies.

scholarly journals An Association of Total Health Expenditure with GDP and Life Expectancy

2017 ◽  
Vol 1 (2) ◽  
pp. AU7-AU12 ◽  
Author(s):  
Sojib Bin Zaman ◽  
Naznin Hossain ◽  
Varshil Mehta ◽  
Shuchita Sharmin ◽  
Shakeel Ahmed Ibne Mahmood
Keyword(s):  
Developing Countries ◽  
Life Expectancy ◽  
Gross Domestic Product ◽  
Health Expenditure ◽  
Health Spending ◽  
Domestic Product ◽  
Fiscal Year ◽  
Total Health Expenditure ◽  
Registration System ◽  
Individual Level

Introduction: Gradual  total health expenditure (THE) has become a major concern. It is not only the increased THE, but also its unequal growth in  overall economy, found among the developing countries. If increased life expectancy is considered as a leverage for an individual’s investment in health services, it can be  expected that as the life expectancy increases, tendency of health care investment will also experience a boost up. Objective: The aim of the present study was to explore and identify the association of healthcare expenditure with the life expectancy and Gross Domestic Product (GDP) in developing countries, especially that of Bangladesh. Methodology: Data were retrospectively collected from “Health Bulletin 2011” and “Sample Vital Registration System 2010” of Bangladesh considering the fiscal year 1996 to fiscal year 2006. Using STATA, multivariable logistic regression was performed to find out the association of total health expenditure with GDP and life expectancy. Results: A direct relationship between GDP and total health expenditure was found through analysing the data. At the individual level, income  had a direct influence on health spending. However, there was no significant relationship between total health expenditure with increased life expectancy. Conclusion: The present study did not find any association between life expectancy and total health expenditure. However, our analysis found out that total health expenditure is more sensitive to gross domestic product rather than life expectancy.

scholarly journals A 15-Year Trend of Catastrophic Health Payment and its Inequality in China: Evidence from Longitudinal Data

2021 ◽  
Author(s):  
Yongjian Xu ◽  
Yiting Zhou ◽  
Andi Pramono
Keyword(s):  
Health Care ◽  
Decomposition Analysis ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Chinese Government ◽  
Nutrition Survey ◽  
Basic Medical Insurance ◽  
Poor Households ◽  
Health Payment ◽  
Basic Medical

Abstract Background：The Chinese health care system has gone through two major cycles of reform since the 1980s. This study aims to comprehensively track the trends in the occurrence of catastrophic health payment and its inequality in the past 15 years, which may help better understand the influence of health system reforms on catastrophic health payment and its inequality. Methods：The study employed the subset of data from China Health and Nutrition Survey conducted from 1991 to 2015. Concentration index and decomposition analysis were used to measure the magnitude of income-related inequality in catastrophic health payment and decompose it into determinants respectively. Results: The incidence of catastrophic health expenditure in China increased from 3.10% in 1993 to 8.90% in 2004, and still maintained at a high level in the following years. The incidence gap of catastrophic health payment between the richest and poorest became increasingly wider over year. Moreover, the adjusted concentration indexes were all negative in each year, decreasing from -0.202 in 1991 to -0.613 in 2015. The basic medical insurance didn’t decrease the incidence of catastrophic health payment and showed the second largest contribution on the inequality in catastrophic health payment before 2004. However, this contribution began to decline after 2006. Conclusions: After the New Health Care Reform, although the Chinese government has taken many measures to protect poor households from catastrophic health payment, the incidence gap between the rich and poor has widened. China has nearly achieved universal coverage in recent years, however, the basic medical insurance in China was not enough to protect households from catastrophic health payment. Our study suggests that improving the generosity of existing basic medical insurance, and reforming the medical insurance payment system would be helpful to reduce the incidence of catastrophic health payment. The use of big data tools and techniques to effectively screen the poor households, and strengthening the social medical aid system would be helpful to decrease the pro-rich inequality in catastrophic health payment.

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