ArticleInternational journal for equity in health2026
Profiling and outcomes of medically indigent patients in Southwest China: a single-center retrospective case series survey study.
Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo understand the characteristics, disease spectrum, clinical outcomes, arrears, and discharge placement conditions of "Medically Indigent Patients (MIPs)," this study aims to provide empirical evidence for administrative departments and hospitals to implement targeted interventions and help alleviate the plight of MIPs.
methodThe retrospective study analyzed electronic records and financial data of MIPs admitted to the Affiliated Hospital of Zunyi Medical University from 2022 to 2024. Differences in costs and arrears across various hospitalization statuses were compared using descriptive statistics with Zstats 1.0, χ² test, and Kruskal-Wallis test.
resultsFrom 2022 to 2024, MIPs numbered 46, 98, and 95, mostly rural residents (227, 94.98%), with many males (202, 84.52%) and a median age of 45. Most admissions occurred through police escort (223, 93.31%), while only a small number (8, 3.35%) were transferred via emergency centers. The disease spectrum included acute alcohol intoxication (82, 34.31%), trauma (52, 21.76%), cerebrovascular accident (40, 16.74%), consciousness disorders (15, 6.28%), pesticide poisoning (11, 4.60%), respiratory and cardiac arrest (11, 4.60%), and other conditions (28, 11.72%). Most MIPs (182, 76.15%) resolved issues with family or friends, but 31 (12.97%) required social workers to coordinate with family, communities, and civil authorities for placement. MIPs management outcomes show that self-discharge remains a challenge: 185 individuals not hospitalized (77.41%) were discharged by family or on their own; 42 hospitalized patients (17.57%) experienced similar discharges; and 12 (5.02%) were discharged through civil channels. Among hospitalized individuals, 54 were admitted-38 to general wards and 16 to the ICU. The median stay was 1 day for non-hospitalized MIPs, 8 days for ward patients, and 20 days for ICU patients, with median costs of ¥1,290.60, ¥22,026.58, and ¥29,434.92, respectively. Hospital stays increased with treatment needs, with 64.02% in arrears totaling over ¥1.1 million, and median arrears of ¥937.24. Costs were ¥2,506.34 for wards and ¥3,970.92 for ICU, worsening the hospital's financial burden. Multivariable logistic regression analysis identified age 40-65 years (OR = 6.77, 95% CI: 1.43-31.99, relative to age < 40 years) and ambulance arrival (OR = 25.03, 95% CI: 2.13-293.85, relative to police escort) as independent predictors of mortality.
conclusionIn southwestern China, MIPs are mainly middle-aged rural men with acute alcohol intoxication or trauma. They frequently rely on passive transfer from the public security system and face challenges including ICU occupancy, unpaid debts, and low placement rates. These findings suggest the need to establish an assessment and transfer process led by social workers, create a relief fund, and promote collaboration among health, civil affairs, public security, and insurance agencies. Further comparative studies are needed to confirm these observations.
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