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The relationship between hemodialysis mortality and the Chinese medical insurance type
Objective: In China, there are two major medical insurance models: the Urban Basic Medical Insurance (UBMI) and the New Cooperative Medical Scheme (NCMS). The aim of the present study was to evaluate the association of the medical insurance type of patients undergoing hemodialysis (HD) with their su...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735307/ https://www.ncbi.nlm.nih.gov/pubmed/31478795 http://dx.doi.org/10.1080/0886022X.2019.1652648 |
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author | Yao, Xi Chen, Shaohua Lei, Wenhua Shi, Nan Lin, Weiqiang Du, Xiaoying Zhang, Ping Chen, Jianghua |
author_facet | Yao, Xi Chen, Shaohua Lei, Wenhua Shi, Nan Lin, Weiqiang Du, Xiaoying Zhang, Ping Chen, Jianghua |
author_sort | Yao, Xi |
collection | PubMed |
description | Objective: In China, there are two major medical insurance models: the Urban Basic Medical Insurance (UBMI) and the New Cooperative Medical Scheme (NCMS). The aim of the present study was to evaluate the association of the medical insurance type of patients undergoing hemodialysis (HD) with their survival. Methods: We retrospectively analyzed the end-stage renal disease adult patients initiating HD between January 2010 and December 2014 in Zhejiang province, followed up through 31 December 2015. Patients who had received HD for over 3 months were separated into two groups, based on different medical insurance type. Demographic, clinical data, and clinical outcomes were analyzed. The survival rates were calculated by using the Kaplan–Meier method. Results: A total of 6779 patients (59 ± 16 years old, 4331 males (63.9%)) with UBMI and 7177 (59 ± 16 years old, 3778 males (52.8%)) with NCMS enrolled from 226 hemodialysis units. Compared with UBMI group, patients with NCMS had a smaller percentage of hypertensive nephropathy, diabetes mellitus and arteriovenous fistula, faced with more problems in anemia, hypoalbuminemia and metabolism of calcium and phosphorous. The 1-, 3- and 5-year survival rates were 95.4%, 84.4%, and 74.1% in UBMI group, 93.1%, 79.7%, and 67.7% in NCMS group, respectively. Patients with NCMS showed higher all-cause mortality compared with UBMI (p < .001). In multivariate Cox proportional hazards model, NCMS was independently associated with higher mortality (AHR = 1.53; 95% CI 1.38 ∼ 1.68). Conclusions: The medical insurance model was independently associated with HD patient survival, NCMS was associated with increased mortality among patients undergoing maintenance hemodialysis in China. |
format | Online Article Text |
id | pubmed-6735307 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-67353072019-09-16 The relationship between hemodialysis mortality and the Chinese medical insurance type Yao, Xi Chen, Shaohua Lei, Wenhua Shi, Nan Lin, Weiqiang Du, Xiaoying Zhang, Ping Chen, Jianghua Ren Fail Clinical Study Objective: In China, there are two major medical insurance models: the Urban Basic Medical Insurance (UBMI) and the New Cooperative Medical Scheme (NCMS). The aim of the present study was to evaluate the association of the medical insurance type of patients undergoing hemodialysis (HD) with their survival. Methods: We retrospectively analyzed the end-stage renal disease adult patients initiating HD between January 2010 and December 2014 in Zhejiang province, followed up through 31 December 2015. Patients who had received HD for over 3 months were separated into two groups, based on different medical insurance type. Demographic, clinical data, and clinical outcomes were analyzed. The survival rates were calculated by using the Kaplan–Meier method. Results: A total of 6779 patients (59 ± 16 years old, 4331 males (63.9%)) with UBMI and 7177 (59 ± 16 years old, 3778 males (52.8%)) with NCMS enrolled from 226 hemodialysis units. Compared with UBMI group, patients with NCMS had a smaller percentage of hypertensive nephropathy, diabetes mellitus and arteriovenous fistula, faced with more problems in anemia, hypoalbuminemia and metabolism of calcium and phosphorous. The 1-, 3- and 5-year survival rates were 95.4%, 84.4%, and 74.1% in UBMI group, 93.1%, 79.7%, and 67.7% in NCMS group, respectively. Patients with NCMS showed higher all-cause mortality compared with UBMI (p < .001). In multivariate Cox proportional hazards model, NCMS was independently associated with higher mortality (AHR = 1.53; 95% CI 1.38 ∼ 1.68). Conclusions: The medical insurance model was independently associated with HD patient survival, NCMS was associated with increased mortality among patients undergoing maintenance hemodialysis in China. Taylor & Francis 2019-09-03 /pmc/articles/PMC6735307/ /pubmed/31478795 http://dx.doi.org/10.1080/0886022X.2019.1652648 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Yao, Xi Chen, Shaohua Lei, Wenhua Shi, Nan Lin, Weiqiang Du, Xiaoying Zhang, Ping Chen, Jianghua The relationship between hemodialysis mortality and the Chinese medical insurance type |
title | The relationship between hemodialysis mortality and the Chinese medical insurance type |
title_full | The relationship between hemodialysis mortality and the Chinese medical insurance type |
title_fullStr | The relationship between hemodialysis mortality and the Chinese medical insurance type |
title_full_unstemmed | The relationship between hemodialysis mortality and the Chinese medical insurance type |
title_short | The relationship between hemodialysis mortality and the Chinese medical insurance type |
title_sort | relationship between hemodialysis mortality and the chinese medical insurance type |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735307/ https://www.ncbi.nlm.nih.gov/pubmed/31478795 http://dx.doi.org/10.1080/0886022X.2019.1652648 |
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