scholarly journals Use of Traditional Chinese Medicine and Its Impact on Medical Cost among Urban Ischemic Stroke Inpatients in China: A National Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zhengwei Huang ◽  
Xuefeng Shi ◽  
Stephen Nicholas ◽  
Elizabeth Maitland ◽  
Yong Yang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Conventional Medicine ◽  
Mainland China ◽  
Medical Insurance ◽  
Inpatient Cost ◽  
Medication Cost ◽  
Cross Sectional ◽  
Basic Medical Insurance ◽  
Conventional Medication ◽  
Basic Medical

Background. Traditional Chinese medicine (TCM) has long been widely adopted by the Chinese people and has been covered by China’s basic medical insurance schemes to treat ischemic stroke. Previous research has mainly highlighted the therapy effect of TCM on ischemic stroke patients. Some studies have demonstrated that employing TCM can reduce the medical burden on other diseases. But no research has explored whether using TCM could reduce inpatient medical cost for ischemic stroke in mainland China. The purpose of this study is to investigate the impact of the use of TCM on the total inpatient cost of ischemic stroke and to explore whether TCM has played the role of being complementary to, or an alternative for, conventional medicine to treat ischemic stroke. Methods. We conducted a national cross-sectional analysis based on a 5% random sample from claims data of China Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) schemes in 2015. Mann–Whitney test was used to compare unadjusted total inpatient cost, conventional medication cost, and nonpharmacy cost estimates. Ordinary least square regression analysis was performed to compare demographics-adjusted total inpatient cost and to examine the association between TCM cost and conventional medication cost. Results. A total of 47321 urban inpatients diagnosed with ischemic stroke were identified in our study, with 92.6% (43843) of the patients using TCM in their inpatient treatment. Total inpatient cost for TCM users was significantly higher than TCM nonusers (USD 1217 versus USD 1036, P < 0.001 ). Conventional medication cost was significantly lower for TCM users (USD 335 versus USD 436, P < 0.001 ). The average cost of TCM per patient among TCM users was USD 289. Among TCM users, conventional medication costs were found to be positively associated with TCM cost after adjusting for confounding factors (Coef. = 0.144, P < 0.001 ). Conclusion. Although the use of TCM reduced the cost of conventional medicine compared with TCM nonusers, TCM imposed an extra financial component on the total inpatient cost on TCM users. Our study suggests that TCM mainly played a complementary role to conventional medicine in ischemic stroke treatment in mainland China.

scholarly journals Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban basic health insurance

2019 ◽  
Author(s):  
Yong yang ◽  
Xiaowei Man ◽  
Shuo Li ◽  
Qian Bai ◽  
Peiwen Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Health Insurance ◽  
Health Services ◽  
Medical Insurance ◽  
Research Association ◽  
Insurance Scheme ◽  
Hospitalization Cost ◽  
Basic Medical Insurance ◽  
Basic Medical ◽  
Out Of Pocket Costs

Abstract Background As one major disease threatening human health, stroke has placed a heavy financial burden on patients worldwide. This study aims to confirm whether there are disparities and inequity in the utilization of inpatient health services for stroke inpatients covered by different health insurance schemes. Methods We conducted statistical analysis based on the data containing urban employee-based basic medical insurance scheme (UEBMI) and urban resident-based basic medical insurance scheme (URBMI) groups, supplied by the China Health Insurance Research Association (CHIRA). Descriptive analysis was the main method to finish this analysis. Results Of the 56485 inpatients who had been diagnosed with ischemic stroke, extracted from the CHIRA claimed database, 64.6% (36487) were covered by UEBMI and 35.4% (19998) were covered by URBMI; the mean age of UEBMI subgroup was slightly older than URBMI subgroup (68.64 and 67.45 years old). The annual frequency of hospitalization of UEBMI subgroup was 1.21 times and 1.15 times for URBMI subgroup. The average length of stay of UEBMI subgroup(13.93days) was longer than URBMI subgroup (10.82 days). The UEBMI group had a higher hospitalization costs but fewer out-of-pocket costs: for the UEBMI subgroup, the average hospitalization cost was RMB11187.64($1724.02), the average total out-of-pocket costs was RMB2646.42($407.81). While for the URBMI subgroup, the average hospitalization cost was RMB6402.27($986.59) and the average total out-of-pocket costs was RMB2746.10($423.17). All the above differences were significant(P<0.001). Meanwhile, patients with UEBMI had higher reimbursement rate (82.65% and 63.82%). Conclusions We found that there were nonnegligible disparities in the utilization of inpatient health services between UEBMI and URBMI as well as health inequity and financial protection inequity. Thus, our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gap in health insurance schemes in China.

Incidence and prevalence of amyotrophic lateral sclerosis in urban China: a national population-based study

2020 ◽  
Vol 91 (5) ◽  
pp. 520-525 ◽  
Author(s):  
Lu Xu ◽  
Lu Chen ◽  
Shengfeng Wang ◽  
Jingnan Feng ◽  
Lili Liu ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Age At Onset ◽  
Mainland China ◽  
Medical Insurance ◽  
Developed Countries ◽  
Urban China ◽  
Pathophysiological Mechanism ◽  
Basic Medical Insurance ◽  
Lateral Sclerosis ◽  
Basic Medical

ObjectiveAmyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease and information on disease burden of ALS in mainland China was limited. We aimed to estimate the prevalence and incidence of ALS in China.MethodsWe used 2012–2016 data from China’s Urban Employee Basic Medical Insurance and Urban Residence Basic Medical Insurance, covering approximately 0.43 billion individuals. ALS cases were identified by the primary diagnosis (International Classification of Diseases code or text of diagnosis) in the insurance database.ResultsThe crude prevalence and incidence in 2016 were 2.91 per 100 000 person-years (95% CI 2.31 to 3.58) and 1.65 (95% CI 1.33 to 2.01), respectively. The standardised prevalence and incidence based on 2010 Chinese census data were 2.97 (95% CI 2.91 to 3.03) and 1.62 (95% CI 1.58 to 1.67), respectively. The annual prevalence between 2013 and 2016 remained relatively constant, ranging from 2.91 (95% CI 2.31 to 3.58) in 2016 to 3.29 (95% CI 2.51 to 4.17) in 2014 (linear regression: β=−0.129, p=0.104). Both rates peaked in the group aged 75–79 years.ConclusionsThe prevalence and incidence of ALS in mainland China were lower than those in developed countries, and maintained a relatively stable trend. The age at onset and age at diagnosis for ALS patients were younger than those in developed countries. Further research is expected to clarify the potential pathophysiological mechanism of ALS.

scholarly journals Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance

2020 ◽  
Author(s):  
Yong Yang ◽  
Xiaowei Man ◽  
Stephen Nicholas ◽  
Shuo Li ◽  
Qian Bai ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Health Insurance ◽  
Health Services ◽  
Medical Insurance ◽  
Research Association ◽  
Insurance Scheme ◽  
Hospitalization Cost ◽  
Basic Medical Insurance ◽  
Basic Medical ◽  
Out Of Pocket Costs

Abstract Background: As the second most common cause of death globally, strokes impose a significant financial burden on patients and a country’s health system. This study demonstrates the disparities in the utilization of inpatient health services for stroke patients covered by different urban basic health insurance schemes in China.Methods: We conducted statistical analysis based on the data containing urban employee-based basic medical insurance scheme (UEBMI) and urban resident-based basic medical insurance scheme (URBMI) groups, supplied by the China Health Insurance Research Association (CHIRA). Descriptive analysis was the main method to finish this study.Results: Of the inpatients (N=56485) who had been diagnosed with ischemic stroke, extracted from the CHIRA claimed database, 64.6% (36487) were covered by UEBMI and 35.4% (19998) were covered by URBMI. The annual frequency of hospitalization of UEBMI subgroup was 1.21 times and 1.15 times for URBMI subgroup. The average length of stay of UEBMI subgroup(13.93days) was longer than URBMI subgroup (10.82 days). The UEBMI group had higher hospitalization costs but fewer out-of-pocket costs: for the UEBMI subgroup, the average hospitalization cost was RMB11187.64($1724.02), the average total out-of-pocket costs was RMB2646.42($407.81). While for the URBMI subgroup, the average hospitalization cost was RMB6402.27($986.59) and the average total out-of-pocket costs was RMB2746.10($423.17). All the above differences were significant(P<0.001). Meanwhile, patients with UEBMI had higher reimbursement rate (82.65% and 63.82%) and lower self-paid ratio (23.65% and 42.89%).Conclusions: We found that there were nonnegligible disparities in the utilization of inpatient health services between UEBMI and URBMI. Thus, our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gap in health insurance schemes in China.

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.

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