China’s Health Expenditure Projections To 2035: Future Trajectory And The Estimated Impact Of Reforms

Zhai, Tiemin; Goss, John; Dmytraczenko, Tania; Zhang, Yuhui; Li, Jinjing; Chai, Peipei

doi:10.1377/hlthaff.2018.05324

Cited by 27 publications

(22 citation statements)

References 19 publications

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“…The hospitalization expenses of patients with CVDs accounted for 70.09% of the treatment expenses in Xinjiang. The rapid growth of inpatient services is the main driving force of the growth of medical expenses [15]. According to the regression analysis of the influencing factors of hospitalization expenses, the length of stay is the most important factor, which is consistent with other research results [16].…”

Section: Discussionsupporting

confidence: 87%

Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”

Zhang

Mao

et al. 2021

Preprint

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Background: This study aims to research the total current curative expenditure (CCE) of cardiovascular and cerebrovascular diseases (CVDs) and their influencing factors in Xinjiang, China. Methods: Through multistage stratified cluster sampling, the sample information of patients with CVDs in Xinjiang, in 2017, was collected. Under the framework of “System of Health Accounts 2011,” the top-down allocation method was used to calculate the CCE of CVDs. Multiple linear regression was used to analyze the influencing factors. Results: The CCE of CVDs in Xinjiang was 10.574 billion yuan; 86.81% of the CCE was spent in hospitals, of which 67.22% went to general hospitals. Coronary heart disease, hypertension, and cerebral infarction were the top three diseases among the treatment cost of CVDs, accounting for 74.20% of the total treatment cost. The CCE of older adults aged 65 years and above accounted for 43.51%. The main factors affecting the hospitalization cost were length of stay, grade of the medical institution, operation, age, payment method, and gender. Conclusions: CVDs consume numerous health funds in Xinjiang; prevention and control work focus on older adults. Further, the flow of treatment cost institutions is unreasonable; thus, the role of primary medical institutions in the prevention and treatment of chronic diseases should be strengthened. Reducing the length of hospital stay can effectively control the CCE.

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Section: Discussionsupporting

confidence: 87%

Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”

Zhang

Mao

et al. 2021

Preprint

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show abstract

“…In the treatment of CCVD, hospitalization expenditure accounted for 74.28%, a review of the costs of disease research in 2009 found that major costs driver of direct cardiovascular disease costs was hospitalization (accounting for 61% of cost in Canada, 40%-45% in the USA and between 34% and 76% in Europe) [29]. Rapid growth in inpatient services is the main driver of increasing health spending [30], so it is meaningful to discuss the influencing factors. We found a significant relationship between the study variables and hospital costs, including the length of hospital stay, surgical insurance status, age, institutional level, and gender, which is consistent with other people's studies [31,32].…”

Section: Viewpoints Research Theme 4: Health Transitions In Chinamentioning

confidence: 99%

How to control the economic burden of treating cardio-cerebrovascular diseases in China? Assessment based on System of Health Accounts 2011

Zhu¹,

Liu²,

Zhang³

et al. 2020

Journal of Global Health

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How to control the economic burden of treating cardio-cerebrovascular diseases in China? Assessment based on System of Health Accounts 2011 Background In the past two decades, chronic non-communicable diseases have become the leading disease burden, and cardio-cerebrovascular diseases (CCVD) are the main causes of death in chronic diseases. It has become the focus of global public health attention, in this study, System of Health Accounts 2011 (SHA 2011) is used to calculate health expenditure, discuss its economic burden, and put forward countermeasures. Methods Data were collected by multi-stage stratified random sampling and the medical expenses of patients with CCVD were calculated based on SHA 2011, from the dimensions of the financing plan, institutional flow, and service function. Correlation and regression analysis were conducted by controlling factors influencing hospitalization expenses. All analysis were conducted by software SPSS. Results The current health expenditure (CHE) of CCVD in Dalian was 3.986 billion Yuan, accounting for 12.88% of the CHE (30.947 billion Yuan). The current curative expenditure (CCE) of CCVD was 2.947 billion Yuan. 40.39% of CCVD financing came from social medical insurance, and the proportion of family health financing was higher (39.06%). The expenditures were consumed by general hospitals and elderly patients. Conclusions The expenditure burden of CCVD in Dalian was massive, and wasted the health resource severely. It is necessary for the government to adjust the financing structure, reallocate the expenses of CCVD, and make institutional flow and functional distribution more reasonable. Electronic supplementary material: The online version of this article contains supplementary material.

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“…With the disease spectrum changing, population aging, medicinal and technological developments, and people's health needs increasing, this problem will get worse in China [3]. According to one study that projected health expenditure in the period 2015-35 in China, the health expenditure is expected to rise to 9.1% of GDP in 2035 [6]. This rapid growth in health expenditure imposes pressures on the government budget as well as on the personal finances of patients, especially in the light of the slowdown in economic growth [7].…”

Section: Introductionmentioning

confidence: 99%

Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016

Zhou

Liao

et al. 2020

IJERPH

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Total health expenditure in China has grown considerably since a new round of health system reform was enacted in 2009. Researchers have shown that strengthening primary healthcare may be an option for countries to solve the rapid expansion of their medical expenditures. This study was designed to explore the association between the strength of primary healthcare and medical expenditures, in the context of the hospital-oriented healthcare system in China. A longitudinal ecological study was conducted using a 5-year panel dataset of 27 provinces in mainland China. The linear mixed effects regression model was used to assess the effects of primary healthcare-related metrics on medical expenditures, controlling for the provincial level specialty care physician supply and socio-economic parameters. All of the three primary healthcare-related metrics showed negative associations with the two medical expenditure parameters. Primary care physicians per 10,000 population was significantly associated with the per capita hospital medical expenditures (p < 0.05), and the percentage of public health expenditure in total health expenditure was significantly associated with both per capita total medical expenditure and per capita hospital medical expenditures (p < 0.01 for both). Our study found negative associations between the primary healthcare capacity and medical expenditure in the context of hospital-oriented healthcare systems in China, adding to the previous evidence that primary healthcare may play a positive role in reducing medical expenditure. Policies on increasing the primary care physician supply and the public share of total health expenditure should be conducted to strengthen the primary healthcare system. With the gradual advance of medical reform and the policy inclination to primary healthcare, this will play a more important role in controlling the rapid growth of medical expenditure.

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China’s Health Expenditure Projections To 2035: Future Trajectory And The Estimated Impact Of Reforms

Cited by 27 publications

References 19 publications

Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”

Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”

How to control the economic burden of treating cardio-cerebrovascular diseases in China? Assessment based on System of Health Accounts 2011

Association between Primary Healthcare and Medical Expenditures in a Context of Hospital-Oriented Healthcare System in China: A National Panel Dataset, 2012–2016

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