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Medical Service Utilization and Direct Medical Cost of Stroke in Urban China

Background: Understanding the treatment costs of stroke can guide health policies and interventions. However, few studies have analyzed the treatment costs of stroke in China. The aim of this study is to assess stroke-related medical service utilization, direct costs of stroke and associated stroke...

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Autores principales: Zhu, Dawei, Shi, Xuefeng, Nicholas, Stephen, Chen, Siyuan, Ding, Ruoxi, Huang, Lieyu, Ma, Yong, He, Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278468/
https://www.ncbi.nlm.nih.gov/pubmed/32702803
http://dx.doi.org/10.34172/ijhpm.2020.111
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author Zhu, Dawei
Shi, Xuefeng
Nicholas, Stephen
Chen, Siyuan
Ding, Ruoxi
Huang, Lieyu
Ma, Yong
He, Ping
author_facet Zhu, Dawei
Shi, Xuefeng
Nicholas, Stephen
Chen, Siyuan
Ding, Ruoxi
Huang, Lieyu
Ma, Yong
He, Ping
author_sort Zhu, Dawei
collection PubMed
description Background: Understanding the treatment costs of stroke can guide health policies and interventions. However, few studies have analyzed the treatment costs of stroke in China. The aim of this study is to assess stroke-related medical service utilization, direct costs of stroke and associated stroke predictors, and, second, to understand the structure of medical resource use. Methods: This study used a 5% random sample of claim data from China’s Urban Basic Medical Insurance between January 2013 to December 2016. The sampling design assigned a sample weight to each beneficiary. Weighted descriptive analyses, Poisson regression and generalized linear model were used to analyze the medical service utilization, costs and their associations with patient characteristics. Results: In urban China, the annual prevalence of stroke was 730.43 (95% CI = 730.10-730.76) cases per 100 000 people, and nearly 2% of total health expenditures of urban residents was spent on stroke-related medical costs. Weighted average annual total medical cost of stroke was RMB10 637 [95% CI = 10 435-10 840] (US$1682, 95% CI = 1650-1714), with annual out-of-pocket (OOP) cost of RMB3093 [95% CI = 3026-3161] (US$489, 95% CI = 478-500). The average yearly number of stroke-related outpatient visit was 1.67 [SD = 3.39] and inpatient admission was 0.79 [SD = 0.83], with an average cost of RMB440 [SD = 739] (US$70, SD = 117) for outpatients and RMB12 702 [SD = 21 424] (US$2008, SD = 3387) for inpatients. Inpatient costs accounted for 94% (RMB10 034 or US$ 1586) of medical costs, and tertiary hospitals were the main provider of stroke care. Stroke-related medical care utilization and direct costs were associated with gender, age, pathological stroke types and insurance status. Medication costs contributed to 50.6% (RMB5382 or US$ 851) of the average stroke-related medical costs. Conclusion: China’s health system bares a large economic burden from stroke. Specific policies are needed to strengthen the capacity of secondary hospitals, alter the structure of medical resource allocation, and target specific sections of the stroke population.
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spelling pubmed-92784682022-07-22 Medical Service Utilization and Direct Medical Cost of Stroke in Urban China Zhu, Dawei Shi, Xuefeng Nicholas, Stephen Chen, Siyuan Ding, Ruoxi Huang, Lieyu Ma, Yong He, Ping Int J Health Policy Manag Original Article Background: Understanding the treatment costs of stroke can guide health policies and interventions. However, few studies have analyzed the treatment costs of stroke in China. The aim of this study is to assess stroke-related medical service utilization, direct costs of stroke and associated stroke predictors, and, second, to understand the structure of medical resource use. Methods: This study used a 5% random sample of claim data from China’s Urban Basic Medical Insurance between January 2013 to December 2016. The sampling design assigned a sample weight to each beneficiary. Weighted descriptive analyses, Poisson regression and generalized linear model were used to analyze the medical service utilization, costs and their associations with patient characteristics. Results: In urban China, the annual prevalence of stroke was 730.43 (95% CI = 730.10-730.76) cases per 100 000 people, and nearly 2% of total health expenditures of urban residents was spent on stroke-related medical costs. Weighted average annual total medical cost of stroke was RMB10 637 [95% CI = 10 435-10 840] (US$1682, 95% CI = 1650-1714), with annual out-of-pocket (OOP) cost of RMB3093 [95% CI = 3026-3161] (US$489, 95% CI = 478-500). The average yearly number of stroke-related outpatient visit was 1.67 [SD = 3.39] and inpatient admission was 0.79 [SD = 0.83], with an average cost of RMB440 [SD = 739] (US$70, SD = 117) for outpatients and RMB12 702 [SD = 21 424] (US$2008, SD = 3387) for inpatients. Inpatient costs accounted for 94% (RMB10 034 or US$ 1586) of medical costs, and tertiary hospitals were the main provider of stroke care. Stroke-related medical care utilization and direct costs were associated with gender, age, pathological stroke types and insurance status. Medication costs contributed to 50.6% (RMB5382 or US$ 851) of the average stroke-related medical costs. Conclusion: China’s health system bares a large economic burden from stroke. Specific policies are needed to strengthen the capacity of secondary hospitals, alter the structure of medical resource allocation, and target specific sections of the stroke population. Kerman University of Medical Sciences 2020-07-20 /pmc/articles/PMC9278468/ /pubmed/32702803 http://dx.doi.org/10.34172/ijhpm.2020.111 Text en © 2022 The Author(s); Published by Kerman University of Medical Sciences https://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 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Zhu, Dawei
Shi, Xuefeng
Nicholas, Stephen
Chen, Siyuan
Ding, Ruoxi
Huang, Lieyu
Ma, Yong
He, Ping
Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title_full Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title_fullStr Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title_full_unstemmed Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title_short Medical Service Utilization and Direct Medical Cost of Stroke in Urban China
title_sort medical service utilization and direct medical cost of stroke in urban china
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278468/
https://www.ncbi.nlm.nih.gov/pubmed/32702803
http://dx.doi.org/10.34172/ijhpm.2020.111
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