ArticleBMC health services research2021
An equity evaluation in stroke inpatients in regard to medical costs in China: a nationwide study.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 16 citations in OpenAlex.
- A study on the impact of DRG payment reform on hospitalization costs and outcomes of patients with fractures and intervertebral disc herniations.Frontiers in public health · 2026Article
- Stroke Diagnosis and Prediction Tool Using ChatGLM: Development and Validation Study.Journal of medical Internet research · 2025Article
- A study of the impact of DIP payment reform on coronary heart disease hospitalization costs and equity.Frontiers in public health · 2025Article
- Influencing factors of hospitalization costs for intensive rehabilitation in patients with post-stroke disorder of consciousness.Frontiers in public health · 2025Article
- Impact of Diagnosis-Related Groups (DRG) reform on cost homogeneity of treatment for patients with malignant tumours.Scientific reports · 2024Article
- The impact of an innovative payment method on medical expenditure, efficiency, and quality for inpatients with different types of medical insurance: evidence from a pilot city, China.International journal for equity in health · 2024Article
- Experience of financial toxicity and coping strategies in young and middle-aged patients with stroke: a qualitative study.BMC health services research · 2024Article
- Hospitalization costs in patients with stroke in southeastern China: a retrospective population-based cohort study, 2019-2022.Frontiers in public health · 2024Article
- Direct medical costs of ischemic heart disease in urban Southern China: a 5-year retrospective analysis of an all-payer health claims database in Guangzhou City.Frontiers in public health · 2023Article
- Equity and prediction of health resource allocation of traditional Chinese medicine in China.PloS one · 2023Article
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7 authors at 4 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke has always been a severe disease and imposed heavy financial burden on the health system. Equity in patients in regard to healthcare utilization and medical costs are recognized as a significant factor influencing medical quality and health system responsiveness. The aim of this study is to understand the equity in stroke patients concerning medical costs and healthcare utilization, as well as identify potential factors contributing to geographic variation in stroke patients' healthcare utilization and costs.
methodsCovering 31 provinces in mainland China, our main data were a 5% random sample of stroke claims from Urban Employees Basic Medical Insurance (UEBMI) and Urban Residents Basic Medical Insurance (URBMI) from 2013 to 2016. The Theil index was employed to evaluate the equity in stroke patients in regard to healthcare utilization and medical costs, and the random-effect panel model was used to explore the impact of province-level factors (health resource factors, enabling factors, and economic factors) on medical costs and health care utilization.
resultsStroke patients' healthcare utilization and medical costs showed significant differences both within and between regions. The UEBMI scheme had an overall lower Theil index value than the URBMI scheme. The intra-region Theil index value was higher than the inter-region Theil index, with the Theil index highest within eastern China, China's richest and most developed region. Health resource factors and enabling factors (represented by reimbursement rate and education attainment years) were identified significantly associated with medical costs (P < 0.05), but have no impact on average length of stay.
conclusionsChina's fragmented urban health insurance schemes require further reform to ensure better equity in healthcare utilization and medical costs for stroke patients. Improving education attainment, offering equal access to healthcare, allocating health resources reasonably and balancing health services prices in different regions also count.
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