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Analysis of influencing factors of economic burden and medical service utilization of diabetic patients in China.

ABSTRACT: BACKGROUND:This study analyzed factors that affect the financial burden and utilization of medical services of patients with diabetes in a city of China. METHODS:We randomly sampled 10% of the information on the front page of diabetic inpatient medical records in the city from January 2014 to September 2019. Total cost of hospitalization, length of hospitalization and the number of hospitalization were analyzed. Descriptive statistical analysis and multiple linear regression analysis were adopted. RESULTS:Understanding the current financial burden of diabetic patients and the use of medical services, the results show that the direct economic burden of diabetic patients per hospitalization was approximately 8,000 Yuan, and the indirect economic burden was approximately 2,000 Yuan. Age, medical payment methods, admission channels, and medical institution grades are all important factors affecting medical expenses and medical service utilization of diabetic patients. In addition, the inequality of medical service utilization of patients is increased due to different types of medical insurance. CONCLUSIONS:To reduce the economic burden on patients and society, governments should strengthen supervision, the advancement of diagnosis and treatment systems, the service conditions of primary medical institutions, the management of medical services, and the use of medical resources. To create a more impartial medical and health environment where the value of medical staff are truly reflected, financial investments should be attained to improve medical technologies and labor costs.

SUBMITTER: Chen C

PROVIDER: S-EPMC7598469 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Analysis of influencing factors of economic burden and medical service utilization of diabetic patients in China.

Chen Chen C Song Jinglin J Xu Xiaolan X Zhou Leming L Wang Yonghong Y Chen Hong H

PloS one 20201030 10

<h4>Background</h4>This study analyzed factors that affect the financial burden and utilization of medical services of patients with diabetes in a city of China.<h4>Methods</h4>We randomly sampled 10% of the information on the front page of diabetic inpatient medical records in the city from January 2014 to September 2019. Total cost of hospitalization, length of hospitalization and the number of hospitalization were analyzed. Descriptive statistical analysis and multiple linear regression analy ...[more]

PMID: 33126237

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Project description:BackgroundTransportation costs can be a barrier to healthcare services, especially for low-income, disabled, elderly, and geographically isolated populations. This study aimed to estimate the transportation costs of healthcare service utilization and related influencing factors in Korea in 2016.MethodsTransportation costs were calculated using data from the 2016 Korea Health Panel Study. A total of 14,845 participants were included (males, 45.07%; females, 54.93%), among which 2,148 participants used inpatient and 14,787 used outpatient care services. Transportation costs were estimated by healthcare types, transportation modes, and all disease and injury groups that caused healthcare service utilization. The influencing factors of higher transportation costs were analyzed using multivariable regression analysis.ResultsIn 2016, the average transportation costs were United States dollars (USD) 43.70 (purchasing power parity [PPP], USD 32.35) per year and USD 27.67 (PPP, USD 20.48) per visit for inpatient care; for outpatient case, costs were USD 41.43 (PPP, USD 30.67) per year and USD 2.09 (PPP, USD 1.55) per visit. Among disease and injury groups, those with neoplasms incurred the highest transportation costs of USD 9.73 (PPP, USD 7.20). Both inpatient and outpatient annual transportation costs were higher among severely disabled individuals (inpatient, +USD 44.71; outpatient, +USD 23.73) and rural residents (inpatient, +USD 20.40; outpatient, +USD 28.66). Transportation costs per healthcare visit were influenced by healthcare coverage and residential area. Sex, age, and income were influencing factors of higher transportation costs for outpatient care.ConclusionTransportation cost burden was especially high among those with major non-communicable diseases (e.g., cancer) or living in rural areas, as well as elderly, severely disabled, and low-income populations. Thus, there is a need to address the socioeconomic disparities related to healthcare transportation costs in Korea by implementing targeted interventions in populations with restricted access to healthcare.

Project description:BackgroundEquitable maternal healthcare service access and it's optimum utilization remains a challenge for many developing countries like Bangladesh, and different predisposing, enabling, and need-based factors affect the level of maternal healthcare use. The evidently poor maternal healthcare service utilization and disparities among groups in Bangladesh are concerning considering its effect on maternal health outcomes. The study aimed to identify the factors that influence maternal healthcare service (MHS) utilization in Bangladesh by adopting Andersen's behavior model of health service use as the theoretical framework.MethodsThe 2017-18 Bangladesh Demographic Health Survey (2017-18 BDHS) data were used which is nationally representative. The survey study used two-stage stratified sampling to select study households, and data were collected through face-to-face interviews. The desirable, moderate, and undesirable maternal health service (MHS) package was developed based on antenatal, and delivery care services use during pregnancy and childbirth. Multinomial logistic regression and discriminant analysis were performed to analyze the factors that affect MHS use.ResultsOut of 5,011 ever-married women, only 31.2% of women utilized the desirable level of MHS. The likelihood of using the desirable level of MHS package, relative to the undesirable category, was 9.38 times (OR: 9.38, 95% CI: 4.30-20.44) higher for women with a higher level of education compared to illiterate women, and the same trend was noticed for husband's education. The wealth index had the highest standardized function coefficients (Beta coefficient: 0.49) in discriminatory function. Women with the richest wealth index were more than 23 times (OR: 23.27, 95% CI: 12.69-42.68) likely to have utilized desirable MHS than their poorest counterparts. The likelihood of service uses also varied according to the child's birth order, administrative regions, and area of residence (rural vs. urban).ConclusionsPolicies and interventions directed towards poverty reduction, universal education, and diminishing geographical disparities of healthcare access might influence the desirable use of maternal healthcare services in Bangladesh.

Project description:BackgroundCommunity health services have played an important role in the prevention and control of diabetes in China. The aims of this study were to examine the frequency of visits to community clinics for diabetic care services, to assess factors correlated with infrequent primary care visits and to identify barriers to regular follow-up visits for urban and rural patients.MethodsBetween October 2014 and November 2014, data were collected from 17 communities in two cities and four townships located in Shandong and Jiangsu Provinces in China. A total of 1598 diabetic patients aged 18 years or older who were registered with a primary health station in local communities were selected by simple random sampling. Each participant was required to complete an interviewer-led questionnaire. Univariate and multivariate analyses were used to identify significant factors for infrequent visitor status using multivariable logistic regression analysis.ResultsAfter being clearly informed of the study protocol, 1508/1598 (94.4%) patients agreed to participate in this survey. Among the 1508 subjects (mean age 64.4 ± 10.6), 683 (45.3%) were classified as infrequent visitors. The following were significant factors determining infrequent visitor status: urban residence, lack of health insurance, per-capita household income< 20,000 (yuan), lack of telephone follow-up and lack of household visit. From the patients' perspectives, the reasons for infrequent visits among urban patients included drug scarcity and longer travel time to clinics. For rural patients, worries about medical expenses and drug scarcity were the most common barriers to clinic visits.ConclusionDeterminants of infrequent community visits in diabetes patients include urban residence, lower household income, lack of health insurance, lack of telephone follow-up and lack of household visit services. Strategies aimed at enhancing the utilization of community health care should be implemented in China.

Project description:BackgroundCritically ill patients need to be immediately identified, properly managed, and rapidly transported to definitive care. Extensive prehospital times may increase mortality in selected patient groups. The on-scene time is a part of the prehospital interval that can be decreased, as transport times are determined mostly by the distance to the hospital. Identifying factors that affect on-scene time can improve training, protocols, and decision making. Our objectives were to assess on-scene time in the Helicopter Emergency Medical Service (HEMS) in our region and selected factors that may affect it in specific and severe conditions.MethodsThis retrospective cohort study evaluated on-scene time and factors that may affect it for 9757 emergency primary missions by the three HEMSs in western Norway between 2009 and 2013, using graphics and descriptive statistics.ResultsThe overall median on-scene time was 10 minutes (IQR 5-16). The median on-scene time in patients with penetrating torso injuries was 5 minutes (IQR 3-10), whereas in cardiac arrest patients it was 20 minutes (IQR 13-28). Based on multivariate linear regression analysis, the severity of the patient's condition, advanced interventions performed, mode of transport, and trauma missions increased the on-scene time. Endotracheal intubation increased the OST by almost 10 minutes. Treatment prior to HEMS arrival reduced the on-scene time in patients suffering from acute myocardial infarction.DiscussionWe found a short OST in preselected conditions compared to other studies. For the various patient subgroups, the strength of association between factors and OST varied. The time spent on-scene and its influencing factors were dependent on the patient's condition. Our results provide a basis for efforts to improve decision making and reduce OST for selected patient groups.ConclusionsThe most important factors associated with increased on-scene time were the severity of the patient's condition, the need for intubation or intravenous analgesic, helicopter transport, and trauma missions.

Dataset Information

Analysis of influencing factors of economic burden and medical service utilization of diabetic patients in China.

Publications

Analysis of influencing factors of economic burden and medical service utilization of diabetic patients in China.

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