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Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study

BACKGROUND: Health insurance plays a significant role in reducing the financial burden for lung cancer patients. However, limited research exists regarding the differences in medical costs for lung cancer patients with different insurance schemes across different cities. We aimed to assess dispariti...

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Autores principales: Li, Yichen, Yang, Yong, Yuan, Jia, Huang, Lieyu, Ma, Yong, Shi, Xuefeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077891/
https://www.ncbi.nlm.nih.gov/pubmed/35524258
http://dx.doi.org/10.1186/s12913-022-07957-9
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author Li, Yichen
Yang, Yong
Yuan, Jia
Huang, Lieyu
Ma, Yong
Shi, Xuefeng
author_facet Li, Yichen
Yang, Yong
Yuan, Jia
Huang, Lieyu
Ma, Yong
Shi, Xuefeng
author_sort Li, Yichen
collection PubMed
description BACKGROUND: Health insurance plays a significant role in reducing the financial burden for lung cancer patients. However, limited research exists regarding the differences in medical costs for lung cancer patients with different insurance schemes across different cities. We aimed to assess disparities in lung cancer patients’ costs by insurance type and city–specific insurance type. METHODS: Claim data of China Urban Employees’ Basic Medical Insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) between 2010 and 2016 were employed to investigate differences in medical costs. This study primarily applied descriptive analysis and a generalized linear model with a gamma distribution and a log link. RESULTS: In total, 92,856 lung cancer patients with inpatient records were identified, with Renminbi (RMB) 11,276 [6322–20,850] (median [interquartile range]) medical costs for the UEBMI group and RMB 8303 [4492–14,823] for the URBMI group. Out–of–pocket (OOP) expenses for the UEBMI group was RMB 2143 [1108–4506] and RMB 2975 [1367–6275] for the URBMI group. The UEBMI group also had significantly higher drug costs, medical service costs, and medical consumable costs, compared to the URBMI group. Regarding city-specific insurances, medical costs for the UEBMI and the URBMI lung cancer patients in Shanghai were RMB 9771 [5183–16,623] and RMB 9741 [5924–16,067], respectively. In Xianyang, the medical costs for UEBMI and URBMI patients were RMB 11,398 [6880–20,648] and RMB 9853 [5370–24,674], respectively. The regression results showed that the UEBMI group had 27.31% fewer OOP expenses than the URBMI group did, while patients in Xiangyang and Xianyang had 39.53 and 35.53% fewer OOP expenses, respectively, compared to patients in Shanghai. CONCLUSIONS: Compared with the URBMI patients, the UEBMI lung cancer patients obtained more or even better health services and had reduced financial burden. The differences in insurances among cities were greater, compared to those among insurances within cities, and the differences in OOP expenses between cities were greater compared to those between UEBMI and URBMI. Our results called for further reform of China’s fragmented insurance schemes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07957-9.
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spelling pubmed-90778912022-05-08 Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study Li, Yichen Yang, Yong Yuan, Jia Huang, Lieyu Ma, Yong Shi, Xuefeng BMC Health Serv Res Research BACKGROUND: Health insurance plays a significant role in reducing the financial burden for lung cancer patients. However, limited research exists regarding the differences in medical costs for lung cancer patients with different insurance schemes across different cities. We aimed to assess disparities in lung cancer patients’ costs by insurance type and city–specific insurance type. METHODS: Claim data of China Urban Employees’ Basic Medical Insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) between 2010 and 2016 were employed to investigate differences in medical costs. This study primarily applied descriptive analysis and a generalized linear model with a gamma distribution and a log link. RESULTS: In total, 92,856 lung cancer patients with inpatient records were identified, with Renminbi (RMB) 11,276 [6322–20,850] (median [interquartile range]) medical costs for the UEBMI group and RMB 8303 [4492–14,823] for the URBMI group. Out–of–pocket (OOP) expenses for the UEBMI group was RMB 2143 [1108–4506] and RMB 2975 [1367–6275] for the URBMI group. The UEBMI group also had significantly higher drug costs, medical service costs, and medical consumable costs, compared to the URBMI group. Regarding city-specific insurances, medical costs for the UEBMI and the URBMI lung cancer patients in Shanghai were RMB 9771 [5183–16,623] and RMB 9741 [5924–16,067], respectively. In Xianyang, the medical costs for UEBMI and URBMI patients were RMB 11,398 [6880–20,648] and RMB 9853 [5370–24,674], respectively. The regression results showed that the UEBMI group had 27.31% fewer OOP expenses than the URBMI group did, while patients in Xiangyang and Xianyang had 39.53 and 35.53% fewer OOP expenses, respectively, compared to patients in Shanghai. CONCLUSIONS: Compared with the URBMI patients, the UEBMI lung cancer patients obtained more or even better health services and had reduced financial burden. The differences in insurances among cities were greater, compared to those among insurances within cities, and the differences in OOP expenses between cities were greater compared to those between UEBMI and URBMI. Our results called for further reform of China’s fragmented insurance schemes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07957-9. BioMed Central 2022-05-07 /pmc/articles/PMC9077891/ /pubmed/35524258 http://dx.doi.org/10.1186/s12913-022-07957-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Li, Yichen
Yang, Yong
Yuan, Jia
Huang, Lieyu
Ma, Yong
Shi, Xuefeng
Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title_full Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title_fullStr Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title_full_unstemmed Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title_short Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
title_sort differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9077891/
https://www.ncbi.nlm.nih.gov/pubmed/35524258
http://dx.doi.org/10.1186/s12913-022-07957-9
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