Health Care Utilization and Costs of Patients With Prostate Cancer in China Based on National Health Insurance Database From 2015 to 2017

Bai, Lin; Wushouer, Haishaerjiang; Huang, Cong; Luo, Zhenhuan; Guan, Xiaodong; Shi, Luwen

doi:10.3389/fphar.2020.00719

Cited by 16 publications

(11 citation statements)

References 44 publications

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“…The results regarding differences between UEBMI and URBMI were consistent with prior studies [ 17 ]. Using the China health and retirement longitudinal study (CHARLS) data, Wang et al [ 18 ] reported that UEBMI had a greater effect in improving healthcare utilization and causing higher medical costs compared with URBMI.…”

Section: Discussionsupporting

confidence: 91%

Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study

Yang

Jia

et al. 2022

BMC Health Serv Res

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Background Health insurance plays a significant role in reducing the financial burden for lung cancer patients. However, limited research exists regarding the differences in medical costs for lung cancer patients with different insurance schemes across different cities. We aimed to assess disparities in lung cancer patients’ costs by insurance type and city–specific insurance type. Methods Claim data of China Urban Employees’ Basic Medical Insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) between 2010 and 2016 were employed to investigate differences in medical costs. This study primarily applied descriptive analysis and a generalized linear model with a gamma distribution and a log link. Results In total, 92,856 lung cancer patients with inpatient records were identified, with Renminbi (RMB) 11,276 [6322–20,850] (median [interquartile range]) medical costs for the UEBMI group and RMB 8303 [4492–14,823] for the URBMI group. Out–of–pocket (OOP) expenses for the UEBMI group was RMB 2143 [1108–4506] and RMB 2975 [1367–6275] for the URBMI group. The UEBMI group also had significantly higher drug costs, medical service costs, and medical consumable costs, compared to the URBMI group. Regarding city-specific insurances, medical costs for the UEBMI and the URBMI lung cancer patients in Shanghai were RMB 9771 [5183–16,623] and RMB 9741 [5924–16,067], respectively. In Xianyang, the medical costs for UEBMI and URBMI patients were RMB 11,398 [6880–20,648] and RMB 9853 [5370–24,674], respectively. The regression results showed that the UEBMI group had 27.31% fewer OOP expenses than the URBMI group did, while patients in Xiangyang and Xianyang had 39.53 and 35.53% fewer OOP expenses, respectively, compared to patients in Shanghai. Conclusions Compared with the URBMI patients, the UEBMI lung cancer patients obtained more or even better health services and had reduced financial burden. The differences in insurances among cities were greater, compared to those among insurances within cities, and the differences in OOP expenses between cities were greater compared to those between UEBMI and URBMI. Our results called for further reform of China’s fragmented insurance schemes.

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Section: Discussionsupporting

confidence: 91%

Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study

Yang

Jia

et al. 2022

BMC Health Serv Res

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“…One possible explanation for the finding is the disparities in insurance benefits and healthcare utilization between the two groups. As previous studies showed, URRBMI patients had a significantly shorter length of hospital stay and higher out-of-pocket expenditures when compared with concurrent UEBMI patients [74][75][76]. To increase satisfaction with health among URRBMI tients, China's policymakers need to further efforts to improve URRBMI benefits, especially its reimbursement level.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the satisfaction with public health insurance programs by patients with chronic diseases in China: a structural equation modeling approach

et al. 2021

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Background China has successfully sustained its universal health insurance coverage over the past decade. Although patient satisfaction has been recognized as an important indicator to measure the performance of insurance programs in China, there is a lack of evidence on how patients with chronic diseases are satisfied with China’s public health insurance programs and whether their satisfaction differs by type of insurance. We aimed to fill the evidence gap. Methods We established a hypothetical model that comprised patients’ awareness of insurance policies, the fulfillment of patients’ expectations of insurance benefits, patients’ perceived value of health insurance coverage, patients’ satisfaction with health insurance programs, patients’ complaints, and trust in health insurance programs. We performed a confirmatory factor analysis by using a structural equation modeling (SEM) approach to examine the hypothesized model. A model-testing survey in 10 tertiary hospitals was conducted between June and October 2018, with a valid sample of 922 insured patients with chronic diseases. Results The SEM model, with good fit indices, showed that patients’ awareness of health insurance policies, insurance program’s fulfillment of expectations, and patients’ perceived value of insurance coverage, positively predicted patient satisfaction (P < 0.01). The fulfillment of patients’ expectations of insurance benefits was the major predictor of satisfaction with health insurance (coefficient = 0.593, P < 0.001), while the patients’ perceived value of insurance coverage had the largest impact on their trust in health insurance (coefficient = 0.409, P < 0.01). Compared to patients with Urban-Rural Resident Basic Medical Insurance, Urban Employee Basic Medical Insurance enrollees had a higher degree of satisfaction with insurance on average (P < 0.01). Despite differences in the degree of satisfaction, the main findings from the SEM were also proved by the multi-group analysis. Conclusions Our findings highlight the importance of incorporating patients’ perceived value as part of the ongoing efforts to increase satisfaction with health insurance by patients, especially those who have chronic diseases. Policymakers are also suggested to formulate evidence-informed reimbursement policies that meet patients’ expectations.

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“…The China Health Insurance Association (CHIRA) employed a two-stage systematic sampling design to obtain a national representative sample of BMI beneficiaries and extracted cross-sectional medical service utilisation data annually from the city-level BMI databases, sampled from 82 cities nationwide, representing about 2% of the total population in Mainland China [ 8 , 9 ]. Using probability proportionate to size sampling, the sampled BMI beneficiaries accounted for 2% of the beneficiaries from the centrally administered municipalities and provincial capitals, 5% of those from the prefecture-level cities, and 10% of those from the counties [8] .…”

Section: Methodsmentioning

confidence: 99%

Psychotropic medication utilisation in adult cancer patients in China: A cross-sectional study based on national health insurance database

Bai

Huang

et al. 2020

The Lancet Regional Health - Western Pacific

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Background: Psychotropic medications are useful to treat psychiatric disorders which are frequently underdiagnosed and undertreated in cancer patients. Evidence on utilisation of psychotropic medications in cancer patients was absent in China. This study aimed to analyse the prevalence and the potential predictors of psychotropic medication use in adult cancer patients in China. Methods: We analysed cross-sectional data from the China Health Insurance Association database in 2015-2017, which contained health care utilisation information for a national representative sample of basic medical insurance beneficiaries. Cancer patients aged above 18 were identified by International Classification of Disease 10th revision code C00-C97. Psychotropic medications were defined following the Anatomical Therapeutic Chemical codes: antipsychotics (N05A), anxiolytics (N05B), hypnotics and sedatives (N05C), and antidepressants (N06A, N06CA). We calculated the prevalence of psychotropic medication use in cancer patients, and applied multivariable logistic regression to identify its potential predictors. Findings: A total of 260,364 adults with cancer were identified in the database, of which 48,111 (18 • 5%) were prescribed at least one psychotropic medication comprising antipsychotics (3763, 1 • 4%), anxiolytics (15,902, 6 • 1%), hypnotics and sedatives (37,040, 14 • 2%), and antidepressants (2379, 0 • 9%). Patients with solid tumours had higher prevalence of psychotropic medication use than patients with lymphoid and hematopoietic malignancies (e.g. female genital organs, adjusted odds ratio (OR) = 2 • 25, 95%CI = 2 • 09-2 • 44). The prevalence of psychotropic medication use in cancer patients in the Eastern region was significantly higher than those of cancer patients in the Western regions (OR = 2 • 33, 95%CI = 2 • 27-2 • 40). Compared with the Urban Rural Resident Basic Medical Insurance beneficiaries, cancer patients covered by the Urban Employee Basic Medical Insurance were more likely to use psychotropic medications (OR = 1 • 18, 95%CI = 1 • 15-1 • 20). Midazolam was the most frequently used psychotropic (21,728, 45 • 2%), and flupentixol-melitracen was the most commonly used antidepressant (1176, 2 • 4%) among all psychotropic medication users in the sample. Interpretation: The prevalence of psychotropic medication use in Chinese adult cancer patients was inequitable. Further attention will be needed to be paid to the mental health of cancer patients in China. Funding: No funding.

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Health Care Utilization and Costs of Patients With Prostate Cancer in China Based on National Health Insurance Database From 2015 to 2017

Cited by 16 publications

References 44 publications

Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study

Differences in medical costs among urban lung cancer patients with different health insurance schemes: a retrospective study

Assessment of the satisfaction with public health insurance programs by patients with chronic diseases in China: a structural equation modeling approach

Psychotropic medication utilisation in adult cancer patients in China: A cross-sectional study based on national health insurance database

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