ArticleBMC public health2020
Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Prophylaxis forBMJ open · 2023Pooled it
- Aggressive end-of-life care among over half a million patients with cancer in Shandong, China, 2017-2022.Journal of global health · 2026Article
- Developing supportive policy environments for hospice care in china: a quantitative policy evaluation based on the PMC-Index model.BMC palliative care · 2025Article
- Factors affecting the place of death in patients with liver cancer in China, 2013-2020: A population-based study.Cancer pathogenesis and therapy · 2025Article
- Association of rurality, type of primary caregiver and place of death with end-of-life medical expenditures among the oldest-old population in China.International journal for equity in health · 2023Article
- Availability of family care resources, type of primary caregiving and home death among the oldest-old: A population-based retrospective cohort study in China.SSM - population health · 2022Article
- Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study.Frontiers in public health · 2022Article
- Place of death and phenomenon of going home to die in Chinese adults: A prospective cohort study.The Lancet regional health. Western Pacific · 2022Article
- Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study.BMC public health · 2020Article
- Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundDisparities in the utilization, expenditures, and quality of care by insurance types have been well documented. Such comparisons have yet to be investigated in end-of-life (EOL) settings in China, where public insurance covers over 95% of the Chinese population. This study examined the associations between health insurance and EOL care in the last six months of life: outpatient visits, emergency department (ED) visits, inpatient services, intensive care unit (ICU) admissions, expenditures, and place of death among the cancer patients.
methodsA total of 398 patients diagnosed with cancer who survived more than 6 months after diagnosis and died from July 2015 to June 2017 in urban Yichang, China, were included. Descriptive analysis and multivariate regression models were used to investigate the bivariate and independent associations, respectively, between health insurance with EOL healthcare utilization, expenditures and place of death.
resultsUrban Employee Basic Medical Insurance (UEBMI) beneficiaries visited EDs more frequently than Urban Resident-based Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS) beneficiaries (marginal effects [95% Confidence Interval]: 2.15 [1.81-2.48] and 1.92 [1.59-2.26], respectively). NRCMS and UEBMI beneficiaries had more hospitalizations than URBMI beneficiaries (1.01 [0.38-1.64] and 0.71 [0.20-1.22], respectively). Compared to URBMI beneficiaries, NRCMS beneficiaries and UEBMI beneficiaries had ¥15,722 and ¥43,241 higher expenditures. Similarly, UEBMI beneficiaries were most likely to die in hospitals, followed by NRCMS (UEBMI vs. NRCMS: 0.23 [0.11-0.36]) and URBMI (UEBMI vs. URBMI: 0.67 [0.57-0.78]) beneficiaries.
conclusionsThe disproportionately lower utilization of EOL care among NRCMS and URBMI beneficiaries, compared to UEBMI beneficiaries, raised concerns regarding quality of EOL care and financial burdens of NRCMS and URBMI beneficiaries. Purposive hospice care intervention might be warranted to address EOL care for these beneficiaries in China.
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