Dataset Information

Utilisation of health services among urban patients who had an ischaemic stroke with different health insurance - a cross-sectional study in China.

ABSTRACT: OBJECTIVES:This study investigates the disparities in the utilisation of patient health services for patients who had a stroke covered by different urban basic health insurance schemes in China. DESIGN:We conducted descriptive analysis based on a 5% random sample from claims data of China Urban Employees' Basic Medical Insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) in 2015, supplied by the China Health Insurance Research Association. SETTING:Chinese urban social insurance system. PARTICIPANTS:A total of 56 485 patients who had a stroke were identified, including 36 487 UEBMI patients and 19 998 URBMI patients. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measures include annual number of hospitalisations, average length of stay (ALOS) and average hospitalisation cost. Out-of-pocket (OOP) cost is the secondary outcome measure. RESULTS:The annual mean number of hospitalisations of UEBMI patients was 1.21 and 1.15 for URBMI patients. The ALOS was significantly longer for UEBMI than for URBMI patients (13.93 vs 10.82, p<0.001). Hospital costs were significantly higher for UEBMI than for URBMI patients (US$1724.02 vs US$986.59 (p<0.001), while the OOP costs were significantly higher for URBMI than for UEBMI patients (US$423.17 vs US$407.81 (p<0.001). Patients with UEBMI had higher reimbursement rate than URBMI patients (79.41% vs 66.92%, p<0.001) and a lower self-paid ratio than URBMI patients (23.65% vs 42.89%, p<0.001). CONCLUSIONS:Significant disparities were found in the utilisation of hospital services between UEBMI and URBMI patients. Our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gaps in China's health insurance schemes.

SUBMITTER: Yang Y

PROVIDER: S-EPMC7549448 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Utilisation of health services among urban patients who had an ischaemic stroke with different health insurance - a cross-sectional study in China.

Yang Yong Y Man Xiaowei X Nicholas Stephen S Li Shuo S Bai Qian Q Huang Lieyu L Ma Yong Y Shi Xuefeng X

BMJ open 20201010 10

<h4>Objectives</h4>This study investigates the disparities in the utilisation of patient health services for patients who had a stroke covered by different urban basic health insurance schemes in China.<h4>Design</h4>We conducted descriptive analysis based on a 5% random sample from claims data of China Urban Employees' Basic Medical Insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) in 2015, supplied by the China Health Insurance Research Association.<h4>Setting</h4>Chinese ...[more]

PMID: 33040017

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Project description:ObjectiveThe objective of the study is to examine the impact of health insurance and social safety net programmes on maternal health service utilisation (MHSU) in Pakistan.DesignCross-sectional.SettingsData were obtained from Pakistan Demographic Health Survey 2017-2018.ParticipantsOut of 12 364 Pakistani ever-married women aged 15-49 years included in the survey sample, 7752 were included in the study.Main outcome measuresThree response variables (antenatal care (ANC) by skilled attendants (<4 visits=inadequate vs 4 or more visits=adequate), health facility-based delivery (home vs health) and postnatal care (yes vs no) were combined to assess MHSU. Health insurance was derived from the question 'are you covered with any health insurance?' and social safety net was derived from enrolment in social safety net programmes. Logistic regression analyses were conducted, and results were reported as ORs with 95% CIs. Results of adjusted logistic regression models were fit to control for individual and community-level factors.ResultPrevalence of social safety net was larger than health insurance (7.7% vs 2.0%) while attendance of ANC+4, facility-based delivery and postnatal care was 48.5% (n=3760), 65.9% (n=5097) and 22.6% (n=1745) respectively, among respondents. Women were twice more likely to access maternal health services when they were covered by health insurance (adjusted OR 2.61, 95% CI 1.19 to 5.74, p<0.017) after adjusting for age at marriage, education level, wealth index, rural/urban area, parity, employment, empowerment status, exposure to media, visits and distance to health facility while no significant association of social safety net programmes with MHSU was found.ConclusionExpanding access to health insurance can provide comprehensive coverage for maternal healthcare services. Social safety net programmes can be made conditional, subject to regular health checkups for mothers and children to improve maternal and child health outcomes.

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Dataset Information

Utilisation of health services among urban patients who had an ischaemic stroke with different health insurance - a cross-sectional study in China.

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Utilisation of health services among urban patients who had an ischaemic stroke with different health insurance - a cross-sectional study in China.

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