Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”

Background: This study aims to research the total current curative expenditure (CCE) of cardiovascular and cerebrovascular diseases (CVDs) and their influencing factors in Xinjiang, China. Methods: Through multistage stratified cluster sampling, the sample information of patients with CVDs in Xinjiang, in 2017, was collected. Under the framework of “System of Health Accounts 2011,” the top-down allocation method was used to calculate the CCE of CVDs. Multiple linear regression was used to analyze the influencing factors. Results: The CCE of CVDs in Xinjiang was 10.574 billion yuan; 86.81% of the CCE was spent in hospitals, of which 67.22% went to general hospitals. Coronary heart disease, hypertension, and cerebral infarction were the top three diseases among the treatment cost of CVDs, accounting for 74.20% of the total treatment cost. The CCE of older adults aged 65 years and above accounted for 43.51%. The main factors affecting the hospitalization cost were length of stay, grade of the medical institution, operation, age, payment method, and gender. Conclusions: CVDs consume numerous health funds in Xinjiang; prevention and control work focus on older adults. Further, the flow of treatment cost institutions is unreasonable; thus, the role of primary medical institutions in the prevention and treatment of chronic diseases should be strengthened. Reducing the length of hospital stay can effectively control the CCE.

Case study of the beneficiary group distribution of curative care expenditure based on SHA 2011 in Xinjiang autonomous region, China

BackgroundThe System of Health Accounts 2011 (SHA 2011) assists in health policy analysis and health expenditure comparison at the international level. Based on SHA 2011, this study analysed the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang, to present suggestions for developing health policies.MethodsA total of 160 health institutions were selected using the multistage stratified random sampling method. An analysis of the agewise CCE distribution, institutional flow, and disease distribution was then performed based on the SHA 2011 accounting framework.ResultsIn 2016, the CCE in Xinjiang was ¥50.05 billion, accounting for 70.18% of current health expenditure and 6.66% of the gross domestic product. The per capita CCE was ¥2366.56. The CCE was distributed differently across age groups, with the highest spending on people over the age of 65 years. The CCE was highest for diseases of the circulatory, respiratory and digestive systems. Most of the expenditure was incurred in hospitals and, to a lesser extent, in primary healthcare institutions. Family health expenditure, especially on children aged 14 years and below, accounted for a relatively high proportion of the CCE.ConclusionSHA 2011 was used to capture data, which was then analysed according to the newly added beneficiary dimension. The findings revealed that the use of medical resources is low, the scale of primary medical institutions needs to be significantly expanded and there is a need to optimise the CCE financing scheme. Therefore, the health policymaking department should optimise the relevant policies and improve the efficiency of health services.

Analysis of the Economic Burden of Noncommunicable Diseases in Dalian City of China, Based on the “System of Health Accounts 2011”

Objectives: Noncommunicable diseases (NCDs) are the leading causes of morbidity and mortality worldwide. Understanding the distribution of diseases can provide a basis for policy formulation and intervention. This study analyses the status of the NCDs spending based on “System of Health Accounts 2011” (SHA 2011), to provide health policy advice to China, and give guidance for other areas in the world.Methods: Data were collected by multi-stage stratified random sampling in 2018. The medical expenses of patients with NCDs were calculated based on SHA 2011, Analyze from funding sources, dimensions of institutional flow, and financing scheme. The factors influencing the cost of hospitalization were analyzed by linear regression. All analyses were conducted by software SPSS 25.0 and STATA 15.0.Results: A total of 392 institutions and 2,478,359 valid items were included for study. The current curative expenditure (CCE) of NCDs was 15.914 billion CNY. 61.78% of NCDs financing came from public financing scheme. The proportion of family health financing (32.56%) was higher. The expenditures were mainly in general hospitals (74.95%). Elderly patients account for the majority (76.35%). Drug expenses, length of stay, and institution level were the major factors affecting hospitalization expenses.Conclusions: NCDs are the main economic burden of diseases in Dalian, and its resources are not allocated reasonably. To reduce the economic burden of NCDs, the government needs to optimize resource allocation, and rationalize institutional flows and functions.

The burden of the current curative expenditure of injury in Dalian, China—a study based on the “system of health accounts 2011”

Background Injury is one of the major public health problems and causes more than 5 million deaths in the world annually. Cases of specific types of injury are life-threatening and heavily-burdened to individuals and society. This study was aimed to assess the financial burden of injury on patients. Methods A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 152,553 valid samples. Subsequently, the distribution of injury current curative expenditure (CCE) in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011 (SHA 2011) using the established database. Results In China, both urban and rural injury mortality rates showed an upward trend of more than 5 percentage points from 2006 to 2016. In Dalian, the CCE of injury reached 1572.73 million RMB, accounting for 7.45% of the total CCE. Those aged 15–24 reported larger proportion of CCE than the other age groups. As for the injuries in body parts, injuries occurred to the spine, lower limb, head and foreign body cost most. Conclusions Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost. Young people should pay attention to protect their head and limbs from injury, and related government sectors should implement preventive and educative measures.

The burden of the current curative expenditure of injury in Dalian,China—A study based on the “System of Health Accounts 2011”

Background: Injury is one of the major public health problems and causes more than 5 million deaths in the world annually. Cases of specific types of injury are life-threatening and heavily-burdened to individuals and society. This study was aimed to assess the financial burden of injury on patients. Methods: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 152553 valid samples. Subsequently, the distribution of injury current curative expenditure (CCE) in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011 (SHA 2011) using the established database. Results: In China, both urban and rural injury mortality rates showed an upward trend of more than 5 percentage points from 2006 to 2016. In Dalian, the CCE of injury reached 1572.73 million RMB, accounting for 7.45% of the total CCE. Those aged 15-24 reported larger proportion of CCE than the other age groups. As for the injuries in body parts, injuries occurred to the spine, lower limb, head and foreign body cost most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost. Young people should pay attention to protect their head and limbs from injury, and related government sectors should implement preventive and educative measures.

The Improvement of Approaches to the Creating of the National Health Accounts in Connection with the Spread of COVID-19

Currently, National Health Accounts specialists are facing the problem of attributing new cost items related to the treatment and prevention of the spread of SARS-CoV-2 coronavirus infection. The current international methodology developed in 2011 by OECD, WHO, and EuroStat specialists "A System of Health Accounts 2011" does not provide approaches to the attribution of health care costs aimed at preventing the pandemic. In this regard, there is an urgent need to review the basic approaches to the formation of costs in the Methodology and the construction of the National Health Accounts for 2021 already taking into account these costs. This article provides ways to address this problem and suggestions for including costs associated with treating and preventing the spread of coronavirus in the structure tables of the National Health Accounts. Keywords: National Health Accounts, pandemic, COVID-19

An Analysis of Economic Burden of Hypertensive Patients Based on “System of Health Accounts 2011” and Multiple Layer Perceptron Neural Network

Background: Hypertension requires long-term treatment and medication, which not only affects people’s health, but also brings heavy economic burden for families and society. Therefore, it is meaningful to reveal the actual personal and socio-economic burdens of hypertension based on a tool recognized internationally to improve management of hypertensive patients and provide more information for policy makers, analysts, and international comparisons. Methods: We collected expense records of 180441 hypertensive outpatients and 14763 inpatients in Shanxi Province of China in 2017. Curative care expenditure for hypertension(CCEht) were analyzed based on System of Health Accounts 2011, and influencing factors were analyzed by multiple layer perceptron (MLP) neural network.Results: In 2017, CCEht was US$ 307.71 million, accounted for 3.63% of the total CCE and 0.14% of GDP in Shanxi Province of China. CCE of hypertensive outpatients (CCEht-out) and inpatients (CCEht-in) accounted for 44.49% and 55.51% of the CCEht, drug fee accounted for 81.55% of CCEht-out and 22.50% of CCEht-in, respectively. CCEht increased from the age of 30, and the highest occured in age 60-69. The patients with the age of 40-79 accounted for 86.49% of total CCEht. CCEht of male patients were generally higher than that of female, and there is a significant difference between CCEht for male and female in terms of age. The diagnosis and treatment capacity of primary health care system had been enhanced. New rural cooperation medical insurance and urban employee basic medical insurance had the trend of overusing, and burden of family healthcare expenditure was still very heavy. In the MLP neural network, the top three influencing factors were drug fee, surgical fee and hospitalization days for inpatients, drug fee, examination fee and test fee for outpatients. Conclusions: To ease the economic burden of hypertensive patients and improve the utilization efficiency of social resources , the policy makers should pay more attention to the hypertensive patients aging 40-79, strengthen prevention and outpatient treatment for young men and the inpatient treatment for women at older ages, further increase support for primary health care system, standardize the treatment and reimbursement of hypertension, and incline the reimbursement policy to outpatient service.

The burden of the current curative expenditure of injury in Dalian, China:based on “System of Health Accounts 2011”

Background: Injury is one of the major public health problems and causes more than 5 million deaths in the world annually. Cases of specific types of injury are life-threatening and heavily-burdened to individuals and society. This study was aimed to assess the financial burden of injury on patients. Methods: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 152553 valid samples. Subsequently, the distribution of injury current curative expenditure (CCE) in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011 (SHA 2011) using the established database. Results: In China, both urban and rural injury mortality rates showed an upward trend of more than 5 percentage points from 2006 to 2016. In Dalian, the CCE of injury reached 1572.73 million RMB, accounting for 7.45% of the total CCE. Those aged 15-24 reported larger proportion of CCE than the other age groups. As for the injuries in body parts, injuries occurred to the spine, lower limb, head and foreign body cost most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost. Young people should pay attention to protect their head and limbs from injury, and related government sectors should implement preventive and educative measures.

The burden of the current curative expenditure of injury in Dalian, China-A study based on “System of Health Accounts 2011”

Background: Injury is one of the major public health problems, which causes more than 5 million deaths in the world every year. Cases of specific types of injury put a great threat to human health and also add a heavy medical burden on individuals and societies. This study is aimed at assessing the financial burden of injury on patients. Methods: A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 152553 valid samples. Subsequently, the distribution of injury current curative expenditure (CCE) in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011(SHA 2011) using the established database. Results: In China, from 2006 to 2016, both urban and rural injury mortality rates showed an upward trend of more than 5 percentage points. In Dalian, the CCE of injury had reached 1572.73 million RMB, accounting for 7.45% of the total curative care expenditure. In the 15-24 age group, the cost of injury accounts for a larger proportion of CCE than other age groups. Among the injuries in different regions of the body, injuries to the spine, lower limb, head and foreign body entering cost the most.Conclusions: Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost. Young people in daily life and work should pay attention to protect their head and limbs from injury, the corresponding units should also do a good job in prevention.