ArticleBMC public health2021
Health care utilization for patients with stroke: a 3-year cross-sectional study of China's two urban health insurance schemes across four cities.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Symptom and Functional Clusters Regarding Patient-Reported Outcome Measures and Associated Factors Among Patients with Stroke: A Multicenter Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Direct Medical Costs of Parkinson's Disease in Southern China: A Cross-Sectional Study Based on Health Insurance Claims Data in Guangzhou City.International journal of environmental research and public health · 2022Article
- Association of Chinese Visceral Adiposity Index and Its Dynamic Change With Risk of Carotid Plaque in a Large Cohort in China.Journal of the American Heart Association · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke is a devastating disease and a major cause of death and disability in China. While existing studies focused mainly on differences in stroke patients' health care utilization by insurance type, this study assesses whether health utilization and medical costs differed by insurance type across four cities in China.
methodsA 5% random sample from the 2014-2016 China Urban Employees' Basic Medical Insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) claims data were collected across four cities, Beijing, Shanghai, Tianjin, and Chongqing. Descriptive statistics and ordinary least squares regression were employed to analyze the data.
resultsWe found that differences in healthcare utilization and inpatient and outpatient medical expenses varied more by city-specific insurance type than they did between the UEBMI and URBMI schemes. For example, the median UEBMI medical outpatient costs in Beijing (RMB500.2) were significantly higher than UEBMI patients in Shanghai (RMB260.8), Tianjin (RMB240.8), and Chongqing (RMB293.0), and Beijing URBMI patients had significantly higher outpatient medical costs (RMB356.9) than URBMI patients in Shanghai (RMB233.4) and Chongqing (RMB211.0), which were significantly higher than Tianjin (RMB156.2). Patients in Chongqing had 66.4% (95% CI: - 0.672, - 0.649) fewer outpatient visits, 13.0% (95% CI: - 0.144, - 0.115) fewer inpatient visits, and 34.2% (95% CI: - 0.366, - 0.318) shorter length of stay than patients in Beijing. The divergence of average length of stay and out-of-pocket (OOP) expenses by insurance type was also greater between cities than the UEMBI-URBMI mean difference.
conclusionsSignificant city-specific differences in stroke patients' healthcare utilization and medical costs reflected inequalities in health care access. The fragmented social health insurance schemes in China should be consolidated to provide patients in different cities equal financial protection and benefit packages and to improve the equity of stroke patient access to health care.
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