scholarly journals Geographic Variations in Stroke Inpatient Healthcare Utilization and Hospital Expenditure Equity in China

2020 ◽  
Author(s):  
Yong Yang ◽  
Stephen Nicholas ◽  
Elizabeth Maitland ◽  
Zhengwei Huang ◽  
Xiaoping Chen ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Theil Index ◽  
Economic Factors ◽  
Stroke Patients ◽  
Geographic Variations ◽  
Enabling Factors ◽  
Hospital Expenditures ◽  
Index Value ◽  
Hospital Expenses ◽  
Basic Medical

Abstract Background: Stroke is a devastating disease that imposes a heavy financial burden on patients and their families and a significant economic cost on a nation’s healthcare system. Under China’s fragmented health insurance system, it was unclear whether geographic variations in healthcare utilization and hospital expenditures lead to healthcare inequities for stroke inpatients. This study assesses the geographic variations in stroke patients’ healthcare utilization and hospital expenses and the potential geographical influencing factors. Methods: Covering all municipalities and provinces in mainland China, our main data were a 5% random sample of stroke claims from the Urban Employees Basic Medical Insurance (UEBMI) and Urban Residents Basic Medical Insurance (URBMI) schemes from 2013 to 2016, totaling 217969 inpatients and 280804 admissions. The Theil index was employed to evaluate the (in)equity in healthcare utilization and hospital expenditures across all 31 mainland Chinese provinces. Using multiple linear regression analysis, the geographic influencing factors, comprising ability to deliver healthcare, geographical accessibility of health services, healthcare-seeking and economic factors, were explored.Results: UEBMI stroke inpatients had higher hospital costs and longer ALOS, but lower OOP expenses than those with URBMI. UEBMI insurance had a lower Theil index value than the URBMI scheme. Stroke patients’ healthcare utilization and hospital expenditures showed significant differences both within and between regions. The intra-region Theil (in)equality index value was higher than the inter-region Theil index, with the Theil index highest within eastern China, China’s richest and most developed region. The ability to deliver healthcare, the enabling factors and the provincial-level economic factors had significant effects (P<0.05) on healthcare utilization and hospital expenses.Conclusions: Our data revealed significant geographic variation in healthcare utilization and hospital expenditures for stroke patients. In addition to differences in the coverage and reimbursements of the UEBMI-URBMI schemes, disparities within regions were associated with the ability to deliver healthcare (open hospital beds per 100 patients), the enabling factors (regional reimbursement rate and regional education level) and the provincial-level economic factors (GDP per capita). China’s fragmented urban health insurance schemes require further reform to ensure better equity in healthcare utilization and hospital expenses.

scholarly journals Prevalence and Geographic Variations of Polypharmacy Among West Virginia Medicaid Beneficiaries

2017 ◽  
Vol 51 (11) ◽  
pp. 981-989 ◽  
Author(s):  
Xue Feng ◽  
Xi Tan ◽  
Brittany Riley ◽  
Tianyu Zheng ◽  
Thomas K. Bias ◽  
...  
Keyword(s):  
Logistic Regression ◽  
West Virginia ◽  
Healthcare Utilization ◽  
Chronic Conditions ◽  
Negative Binomial ◽  
Spatial Association ◽  
Emergency Department Visits ◽  
Fee For Service ◽  
Geographic Variations ◽  
Medicaid Beneficiaries

Background: West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens. Objective: To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries. Methods: In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570). We defined polypharmacy as simultaneous use of drugs from five or more different drug classes on a daily basis for at least 60 consecutive days in one year. Multilevel logistic regression was used to explore the individual- and county-level factors associated with polypharmacy. Its relationship with healthcare utilization was assessed using negative binomial regression and logistic regression. The univariate local indicators of spatial association method was applied to explore spatial patterns of polypharmacy in WV. Results: The prevalence of polypharmacy among WV Medicaid beneficiaries was 44.6%. High-high clusters of polypharmacy were identified in southern WV, indicating counties with above-average prevalence surrounded by counties with above-average prevalence. Polypharmacy was associated with being older, female, eligible for Medicaid due to cash assistance or medical eligibility, having any chronic conditions or more chronic conditions, and living in a county with lower levels of education. Polypharmacy was associated with more hospitalizations, emergency department visits, and outpatient visits, as well as higher non-drug medical expenditures. Conclusions: Polypharmacy was prevalent among WV Medicaid beneficiaries and was associated with substantial healthcare utilization and expenditures. The clustering of high prevalence of polypharmacy in southern WV may suggest targeted strategies to reduce polypharmacy burden in these areas.

scholarly journals Convergence Analysis of Economic Growth in South Kalimantan Province 2011-2019

JEJAK ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 304-315
Author(s):  
Wira Yasari
Keyword(s):  
Economic Growth ◽  
Income Inequality ◽  
Pearson Correlation ◽  
Secondary Data ◽  
Theil Index ◽  
Income Per Capita ◽  
Per Capita ◽  
Index Value ◽  
Analytical Tools ◽  
The Relationship

This study aims to analyze the convergence of economic growth in South Kalimantan Province in 2011-2019 based on the level of income per capita. The population of this research is the districts in South Kalimantan Province. Subjects take in the form of levels of income per capita with secondary data sourced from BPS. The analytical tools used are economic growth, Theil index, Williamson index, and Klassen typology model. This study also analyzes the relationship between economic growth and income inequality using Pearson correlation analysis. The results of this study indicate that there is a convergence of inequality in South Kalimantan Province in 2011-2019 with an average Williamson Index value at 0.496 and Theil index at 17.928. Based on the Klassen typology classification, only Tapin District is in the category of high developed and fast growing region. The output on the Pearson analysis correlation shows that there is a non-significant positive correlation between economic growth and income inequality. Furthermore, South Kalimantan Province does not support on the Kuznets hypothesis for the period 2011-2019.

scholarly journals Multi-Level Social Health Insurance System in the Age of Frequent Employment Change: The Urban Unemployment-Induced Insurance Transition and Healthcare Utilization in China

Healthcare ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 77 ◽  
Author(s):  
Bocong Yuan ◽  
Jiannan Li ◽  
Lily Wu ◽  
Zhaoguo Wang
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Insurance System ◽  
Employment Change ◽  
Insurance System ◽  
Social Health Insurance System ◽  
Multi Level ◽  
Basic Medical

Job tenure has been significantly shortened with the prevalence of the gig economy around the world. Workers are faced with a new age of frequent employment change. This emerging situation is out of expectation of social health insurance policymakers. As the multi-level social health insurance system in China is closely associated with employment status; urban workers cannot enjoy the urban employee basic medical insurance (UEBMI) during the unemployment period. At this time, unemployed rural-to-urban migrant workers can only rely on the new cooperative medical scheme (NCMS) and unemployed urban residents can only rely on the urban resident basic medical insurance (URBMI). This study provides a preliminary analysis on healthcare utilization change triggered by the unemployment-induced social health insurance transition that has never been investigated. Using the data of a nationwide survey, empirical results show that the unemployment-induced social health insurance transition can significantly deteriorate the healthcare utilization of insurance beneficiaries experiencing the transitions from the UEBMI to the NCMS (or from the UEBMI to the URBMI). Specifically, the outpatient service quality and the conventional physical examination become worse, and the out-of-pocket expenditure increases. Therefore, the multi-level social health insurance system currently in effect can expose workers to a high risk of insufficient health security in the age of frequent employment change.

scholarly journals Pengaruh Karakteristik Sosial - Ekonomi Masyarakat Terhadap Pola Permukiman di Bantaran / Tepian Sungai Kahayan Kota Palangkaraya

2015 ◽  
Vol 11 (3) ◽  
pp. 340
Author(s):  
Nurhikmah Paddiyatu ◽  
Wisnu Pradoto
Keyword(s):  
Settlement Patterns ◽  
Environmental Influence ◽  
Economic Conditions ◽  
Economic Factors ◽  
Economic Aspects ◽  
Spread Pattern ◽  
Thematic Approach ◽  
Quantitative Descriptive ◽  
Index Value ◽  
Socio Economic Factors

Based on RDTR of Palangkarya City in 2009, Kahayan riverside area is included in the green belt /conservation zone. But the facts, there are utilizations of water bodies as residential land, besides; housing problems are growing organically throughout the location of the study area. Based on these points,the purpose of this study is to analyze characteristics of the society based on socio-economic factors that people take into consideration to live there and to know its influence on the pattern of spread of Kahayan riverside settlements in Palangkaraya. The approach used in this research is quantitative descriptive and thematic approach. Coverage of discussion / substance in this study is about the socio-economic characteristics of the community as well as the physical characteristics of Kahayan riverside neighborhoods, and the factors that are considered by society to live, as well as its influence on the spread pattern of Kahayan riverside settlement area. As for the results, the overall socio-economic characteristics and environmental influence the characteristics of the settlement pattern in Kahayan riverside area significantly (over 80%). Where the results of the crosstab analysis, variables that have been identified in the economic characteristics such as (livelihood, income level) influence by 82%. While the specific characteristics of social (ethnic) by 76% and physical-environmental characteristics (topography) 88%. It is proved that the socio-economic aspects indirectly affect the patterns of people’s settlement. Socio-economic conditions of the riverside area community in the study area indicates that the livelihoods that "near by home" became the reason in preferenced settlement with a dominant percentage, equal to 32.5%. In the aspect of physical condition, the highest percentage of 47.26% with 813 dwellings located on a slope of 0-8% which is lower classification. NNA results obtained dispersed pattern or evenly spread with an index value ratio> 2.58 is equal to 34.3. All the results of analysis are formulated in the zoning plan formulation with resettlement concept and settlement patterns, where the development of settlement patterns are in accordance with socio-economic characteristics in the study area is a grid across the Langkai and Pahandut Seberang villages and pattern combination in the Pahandut village.

scholarly journals Assessment of Geographic Variations regarding the Transportation of Stroke Patients in Korea

2015 ◽  
Vol 22 (4) ◽  
pp. 219-225
Author(s):  
Yd Sohn ◽  
Jy Ahn ◽  
Sm Park ◽  
Yh Lee ◽  
Hc Ahn
Keyword(s):  
Stroke Patients ◽  
Geographic Variations

scholarly journals A Spatio-Temporal Pattern and Socio-Economic Factors Analysis of Improved Sanitation in China, 2006–2015

2018 ◽  
Vol 15 (11) ◽  
pp. 2510 ◽  
Author(s):  
Qing Luo ◽  
Mengjie Zhang ◽  
Wei Yao ◽  
Yanfen Fu ◽  
Haichun Wei ◽  
...  
Keyword(s):  
Rural China ◽  
Theil Index ◽  
Economic Factors ◽  
Spatial Panel ◽  
Panel Model ◽  
Improved Sanitation ◽  
Spatial Panel Model ◽  
Spatio Temporal ◽  
Statistical Yearbook ◽  
Socio Economic Factors

Ensuring an adequate and safe access to sanitation is essential to prevent diseases. Using provincial spatial panel data reported in the China Health Statistical Yearbook and the China Statistical Yearbook, this paper analyzed the spatio-temporal characteristics of improved rural sanitation in 30 Chinese provinces during the period 2006–2015, and analyzed factors that may affect improved sanitation rates in rural China. Spatial autocorrelations of improved sanitation rates were computed via Global and Local Moran’s I firstly, and then, inter-provincial disparities of improved sanitation were assessed by using the Theil index estimator; finally, the spatial panel model was employed to examine the potential socio-economic factors. Spatial autocorrelations results suggested that the provincial improved sanitation rates changes affect both the provinces themselves and the adjacent regions; Analysis of the spatial panel model revealed that factors such as GDP per capita, investment proportion ratio, centralized water supply, rural residents’ expenditure were positively associated with improved sanitation rates, and illiteracy rate of people older than 15 was negatively related with improved sanitation rates. Socio-economic factors had affected the improved sanitation rates in 30 provinces in rural China. Thus, a series of policies, socio-economic measures and personal latrine literacy education should be given to improve the status of improved sanitation rates in rural China.

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