Department of Statistics, School of Economics, Xiamen University, Xiamen, China.
PLoS One. 2012;7(12):e52928. doi: 10.1371/journal.pone.0052928. Epub 2012 Dec 28.
The main goal of this study is to examine the associations between illness conditions and out-of-pocket medical expenditure with other types of household consumptions. In November and December of 2011, a survey was conducted in three cities in western China, namely Lan Zhou, Gui Lin and Xi An, and their surrounding rural areas.
Information on demographics, income and consumption was collected on 2,899 households. Data analysis suggested that the presence of household members with chronic diseases was not associated with characteristics of households or household heads. The presence of inpatient treatments was significantly associated with the age of household head (p-value 0.03). The level of per capita medical expense was significantly associated with household size, presence of members younger than 18, older than 65, basic health insurance coverage, per capita income, and household head occupation. Adjusting for confounding effects, the presence of chronic diseases was negatively associated with the amount of basic consumption (p-value 0.02) and the percentage of basic consumption (p-value 0.01), but positively associated with the percentage of insurance expense (p-value 0.02). Medical expenditure was positively associated with all other types of consumptions, including basic, education, saving and investment, entertainment, insurance, durable goods, and alcohol/tobacco. It was negatively associated with the percentage of basic consumption, saving and investment, and insurance.
Early studies conducted in other Asian countries and rural China found negative associations between illness conditions and medical expenditure with other types of consumptions. This study was conducted in three major cities and surrounding areas in western China, which had not been well investigated in published literature. The observed consumption patterns were different from those in early studies, and the negative associations were not observed. This study may complement the existing rural studies and provide useful information on western Chinese cities.
本研究的主要目的是检验疾病状况和自付医疗支出与其他类型家庭消费之间的关联。2011 年 11 月至 12 月,在中国西部的三个城市兰州、桂林和西安及其周边农村地区进行了一项调查。
共收集了 2899 户家庭的人口统计学、收入和消费信息。数据分析表明,家庭中存在慢性病患者与家庭或户主的特征无关。住院治疗的存在与户主年龄显著相关(p 值为 0.03)。人均医疗费用水平与家庭规模、18 岁以下、65 岁以上成员的存在、基本医疗保险覆盖范围、人均收入和户主职业显著相关。在调整混杂因素的影响后,慢性病的存在与基本消费额(p 值为 0.02)和基本消费额比例(p 值为 0.01)呈负相关,但与保险支出比例(p 值为 0.02)呈正相关。医疗支出与包括基本消费、教育、储蓄和投资、娱乐、保险、耐用品和酒精/烟草在内的所有其他类型的消费呈正相关。它与基本消费、储蓄和投资以及保险的比例呈负相关。
早期在其他亚洲国家和中国农村进行的研究发现,疾病状况和医疗支出与其他类型的消费之间存在负相关关系。本研究在中国西部的三个主要城市及其周边地区进行,这些地区在已发表的文献中尚未得到充分研究。观察到的消费模式与早期研究不同,没有观察到负相关关系。本研究可以补充现有的农村研究,并为中国西部城市提供有用的信息。