Ontology highlight
ABSTRACT: Objective
Although more than 95% of the population is insured by urban or rural insurance programmes in China, little research has been done on insurance-related outcome disparities for patients with acute stroke and transient ischaemic attack (TIA). This study aimed to examine the relationship between insurance status and 1-year outcomes for patients with stroke and TIA.Methods
We abstracted 24?941 patients with acute stroke and TIA from the China National Stroke Registry II. Insurance status was categorised as Urban Basic Medical Insurance Scheme (UBMIS), New Rural Cooperative Medical Scheme (NRCMS) and self-payment. The relationship between insurance status and 1-year outcomes, including all-cause death, stroke recurrence and disability, was analysed using the shared frailty model in the Cox model or generalised estimating equation with consideration of the hospital's cluster effect.Results
About 50% of patients were covered by UBMIS, 41.2% by NRCMS and 8.9% by self-payment. Compared with patients covered by UBMIS, patients covered by NRCMS had a significantly higher risk of all-cause death (9.7% vs 8.6%, adjusted HR: 1.32 (95% CI 1.17 to 1.48), p<0.001), stroke recurrence (7.2% vs 6.5%, adjusted HR: 1.12 (95% CI 1.11 to 1.37), p<0.001) and disability (32.0% vs 26.3%, adjusted OR: 1.29 (95% CI 1.21 to 1.39), p<0.001). Compared with patients covered by UBMIS, self-payment patients had a similar risk of death and stroke recurrence but a higher risk of disability.Conclusions
Patients with stroke and TIA demonstrated differences in 1-year mortality, stroke recurrence and disability between urban and rural insurance groups in China.
SUBMITTER: Gu HQ
PROVIDER: S-EPMC6074626 | biostudies-literature | 2018 Aug
REPOSITORIES: biostudies-literature
Gu Hong-Qiu HQ Li Zi-Xiao ZX Zhao Xing-Quan XQ Liu Li-Ping LP Li Hao H Wang Chun-Juan CJ Yang Xin X Rao Zhen-Zhen ZZ Wang Chun-Xue CX Pan Yue-Song YS Wang Yi-Long YL Wang Yong-Jun YJ
BMJ open 20180801 7
<h4>Objective</h4>Although more than 95% of the population is insured by urban or rural insurance programmes in China, little research has been done on insurance-related outcome disparities for patients with acute stroke and transient ischaemic attack (TIA). This study aimed to examine the relationship between insurance status and 1-year outcomes for patients with stroke and TIA.<h4>Methods</h4>We abstracted 24 941 patients with acute stroke and TIA from the China National Stroke Registry II. In ...[more]