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学科主题: 临床医学
题名:
Role of Health Insurance in Averting Economic Hardship in Families After Acute Stroke in China
作者: Heeley, Emma1; Anderson, Craig S.1; Huang, Yining2,3; Jan, Stephen1; Li, Yan4; Liu, Ming5; Sun, Jian6; Xu, En7; Wu, Yangfeng6; Yang, Qidong8; Zhang, Jingfen9; Zhang, Shihong5; Wang, Jiguang4; ChinaQUEST Investigators
关键词: epidemiology ; health policy ; stroke
刊名: STROKE
发表日期: 2009-06-01
DOI: 10.1161/STROKEAHA.108.540054
卷: 40, 期:6, 页:2149-2156
收录类别: SCI ; SSCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Peripheral Vascular Disease
研究领域[WOS]: Neurosciences & Neurology ; Cardiovascular System & Cardiology
关键词[WOS]: CHRONIC DISEASES ; LOW-INCOME ; CARE ; REFORM ; CHALLENGES ; PAYMENTS ; COUNTRIES ; SCHEME ; SYSTEM ; ASIA
英文摘要:

Background and Purpose-Stroke is a major health burden in China, but there are limited data on its economic effects on households. We aimed to examine the economic impact of stroke and to assess the influence of health insurance.

Methods-In a nationwide, prospective, 62-hospital registry study of acute stroke in China, we recorded information on patient demographics, clinical features, socioeconomic factors, management, and costs of medical care. Information on out-of-pocket health expenses was obtained in surviving patients at 3- and 12-month follow-up. Catastrophic healthcare payments, defined as >= 30% of total household annual income, were estimated from reported household annual income.

Results-Among 4739 3- month survivors of stroke with outcome data, average hospital and medication costs were 16 525 Chinese Yuan Renminbi (US $ 2361) and out-of-pocket costs were 14 478 Chinese Yuan Renminbi (US $ 2068). Overall, 3384 (71%) patients had experienced catastrophic out-of-pocket expenditure. Workers without health insurance were 7 times (OR, 6.9; 95% CI, 4.6 to 10.3) more likely to experience catastrophic payments than workers with insurance. Health insurance also protected against catastrophic payments in patients who were either retired or not working (no insurance: OR, 4.7; 95% CI, 3.1 to 7.2; OR, 1.82; 95% CI, 1.3 to 2.6, respectively).

Conclusions-Because healthcare costs are high relative to income in China, families face considerable economic hardship after stroke. Health insurance protects families against catastrophic healthcare payments, thus highlighting the need to accelerate the ongoing process of building a comprehensive healthcare system in both urban and rural settings in China. (Stroke. 2009; 40: 2149-2156.)

语种: 英语
项目资助者: Macquarie Bank Foundation ; The George Foundation ; AstraZeneca Pharmaceutical China ; AusAID Australian Youth Ambassadors for Development
WOS记录号: WOS:000266302200036
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/58605
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Sichuan Univ, W China Hosp, Chengdu 610064, Peoples R China
2.Xiangya Hosp Ctr S Univ, Changsha, Hunan, Peoples R China
3.Baotou Cental Hosp, Baotou, Inner Mongolia, Mongol Peo Rep
4.Royal Prince Alfred Hosp, George Inst Int Hlth, Sydney, NSW, Australia
5.Univ Sydney, Sydney, NSW 2006, Australia
6.Peking Univ, Hosp 1, Beijing 100871, Peoples R China
7.Shanghai Jiao Tong Univ, Rui Jin Hosp, Shanghai Inst Hypertens, Shanghai 200030, Peoples R China
8.Peking Univ, Hlth Sci Ctr, George Inst China, Beijing, Peoples R China
9.Guangzhou Med Coll, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China

Recommended Citation:
Heeley, Emma,Anderson, Craig S.,Huang, Yining,et al. Role of Health Insurance in Averting Economic Hardship in Families After Acute Stroke in China[J]. STROKE,2009,40(6):2149-2156.
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