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Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study

OBJECTIVES: To determine insurance-related disparities in hospital care for patients with acute myocardial infarction (AMI), heart failure (HF) and pneumonia. SETTING AND PARTICIPANTS: A total of 22 392 patients with AMI, 8056 patients with HF and 17 161 patients with pneumonia were selected from 31...

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Autores principales: Lin, Xiaojun, Cai, Miao, Tao, Hongbing, Liu, Echu, Cheng, Zhaohui, Xu, Chang, Wang, Manli, Xia, Shuxu, Jiang, Tianyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642755/
https://www.ncbi.nlm.nih.gov/pubmed/28765128
http://dx.doi.org/10.1136/bmjopen-2017-015884
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author Lin, Xiaojun
Cai, Miao
Tao, Hongbing
Liu, Echu
Cheng, Zhaohui
Xu, Chang
Wang, Manli
Xia, Shuxu
Jiang, Tianyu
author_facet Lin, Xiaojun
Cai, Miao
Tao, Hongbing
Liu, Echu
Cheng, Zhaohui
Xu, Chang
Wang, Manli
Xia, Shuxu
Jiang, Tianyu
author_sort Lin, Xiaojun
collection PubMed
description OBJECTIVES: To determine insurance-related disparities in hospital care for patients with acute myocardial infarction (AMI), heart failure (HF) and pneumonia. SETTING AND PARTICIPANTS: A total of 22 392 patients with AMI, 8056 patients with HF and 17 161 patients with pneumonia were selected from 31 tertiary hospitals in Shanxi, China, from 2014 to 2015 using the International Classification of Diseases, Tenth Revision codes. Patients were stratified by health insurance status, namely, urban employee-based basic medical insurance (UEBMI), urban resident-based basic medical insurance (URBMI), new cooperative medical scheme (NCMS) and self-payment. OUTCOME MEASURES: Inhospital mortality and length of stay (LOS). RESULTS: The highest unadjusted inhospital mortality rate was detected in NCMS patients independent of medical conditions (4.7%, 4.4% and 11.1% for AMI, HF and pneumonia, respectively). The lowest unadjusted inhospital mortality rate and the longest LOS were observed in UEBMI patients. After controlling patient-level and hospital-level covariates, the adjusted inhospital mortality was significantly higher for NCMS and self-payment among patients with AMI, for NCMS among patients with HF and for URBMI, NCMS and self-payment among patients with pneumonia compared with UEBMI. The LOS of the URBMI, NCMS and self-payment groups was significantly shorter than that of the UEBMI group. CONCLUSION: Insurance-related disparities in hospital care for patients with three common medical conditions were observed in this study. NCMS patients had significantly higher adjusted inhospital mortality and shorter LOS compared with UEBMI patients. Policies on minimising the disparities among different insurance schemes should be established by the government.
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spelling pubmed-56427552017-10-25 Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study Lin, Xiaojun Cai, Miao Tao, Hongbing Liu, Echu Cheng, Zhaohui Xu, Chang Wang, Manli Xia, Shuxu Jiang, Tianyu BMJ Open Health Policy OBJECTIVES: To determine insurance-related disparities in hospital care for patients with acute myocardial infarction (AMI), heart failure (HF) and pneumonia. SETTING AND PARTICIPANTS: A total of 22 392 patients with AMI, 8056 patients with HF and 17 161 patients with pneumonia were selected from 31 tertiary hospitals in Shanxi, China, from 2014 to 2015 using the International Classification of Diseases, Tenth Revision codes. Patients were stratified by health insurance status, namely, urban employee-based basic medical insurance (UEBMI), urban resident-based basic medical insurance (URBMI), new cooperative medical scheme (NCMS) and self-payment. OUTCOME MEASURES: Inhospital mortality and length of stay (LOS). RESULTS: The highest unadjusted inhospital mortality rate was detected in NCMS patients independent of medical conditions (4.7%, 4.4% and 11.1% for AMI, HF and pneumonia, respectively). The lowest unadjusted inhospital mortality rate and the longest LOS were observed in UEBMI patients. After controlling patient-level and hospital-level covariates, the adjusted inhospital mortality was significantly higher for NCMS and self-payment among patients with AMI, for NCMS among patients with HF and for URBMI, NCMS and self-payment among patients with pneumonia compared with UEBMI. The LOS of the URBMI, NCMS and self-payment groups was significantly shorter than that of the UEBMI group. CONCLUSION: Insurance-related disparities in hospital care for patients with three common medical conditions were observed in this study. NCMS patients had significantly higher adjusted inhospital mortality and shorter LOS compared with UEBMI patients. Policies on minimising the disparities among different insurance schemes should be established by the government. BMJ Publishing Group 2017-08-01 /pmc/articles/PMC5642755/ /pubmed/28765128 http://dx.doi.org/10.1136/bmjopen-2017-015884 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Policy
Lin, Xiaojun
Cai, Miao
Tao, Hongbing
Liu, Echu
Cheng, Zhaohui
Xu, Chang
Wang, Manli
Xia, Shuxu
Jiang, Tianyu
Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title_full Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title_fullStr Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title_full_unstemmed Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title_short Insurance status, inhospital mortality and length of stay in hospitalised patients in Shanxi, China: a cross-sectional study
title_sort insurance status, inhospital mortality and length of stay in hospitalised patients in shanxi, china: a cross-sectional study
topic Health Policy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642755/
https://www.ncbi.nlm.nih.gov/pubmed/28765128
http://dx.doi.org/10.1136/bmjopen-2017-015884
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