Department of Statistics, Xiamen University, Xiamen, China.
BMC Public Health. 2013 Aug 12;13:743. doi: 10.1186/1471-2458-13-743.
Illness conditions lead to medical expenditure. Even with various types of medical insurance, there can still be considerable out-of-pocket costs. Medical expenditure can affect other categories of household consumptions. The goal of this study is to provide an updated empirical description of the distributions of illness conditions and medical expenditure and their associations with other categories of household consumptions.
A phone-call survey was conducted in June and July of 2012. The study was approved by ethics review committees at Xiamen University and FuJen Catholic University. Data was collected using a Computer-Assisted Telephone Survey System (CATSS). "Household" was the unit for data collection and analysis. Univariate and multivariate analyses were conducted, examining the distributions of illness conditions and the associations of illness and medical expenditure with other household consumptions.
The presence of chronic disease and inpatient treatment was not significantly associated with household characteristics. The level of per capita medical expenditure was significantly associated with household size, income, and household head occupation. The presence of chronic disease was significantly associated with levels of education, insurance and durable goods consumption. After adjusting for confounders, the associations with education and durable goods consumption remained significant. The presence of inpatient treatment was not associated with consumption levels. In the univariate analysis, medical expenditure was significantly associated with all other consumption categories. After adjusting for confounding effects, the associations between medical expenditure and the actual amount of entertainment expenses and percentages of basic consumption, savings, and insurance (as of total consumption) remained significant.
This study provided an updated description of the distributions of illness conditions and medical expenditure in Taiwan. The findings were mostly positive in that illness and medical expenditure were not observed to be significantly associated with other consumption categories. This observation differed from those made in some other Asian countries and could be explained by the higher economic status and universal basic health insurance coverage of Taiwan.
疾病状况导致医疗支出。即使有各种类型的医疗保险,仍可能有相当大的自付费用。医疗支出会影响其他类别的家庭消费。本研究的目的是提供疾病状况和医疗支出的分布及其与其他类别的家庭消费之间关联的最新实证描述。
2012 年 6 月至 7 月进行了电话调查。该研究得到了厦门大学和辅仁天主教大学伦理审查委员会的批准。使用计算机辅助电话调查系统(CATSS)收集数据。“家庭”是数据收集和分析的单位。进行了单变量和多变量分析,检查疾病状况的分布以及疾病和医疗支出与其他家庭消费的关联。
慢性病和住院治疗的存在与家庭特征无显著关联。人均医疗支出水平与家庭规模、收入和家庭主要职业显著相关。慢性病的存在与教育程度、保险和耐用品消费显著相关。在调整了混杂因素后,与教育和耐用品消费的关联仍然显著。住院治疗的存在与消费水平无关。在单变量分析中,医疗支出与所有其他消费类别均显著相关。在调整了混杂效应后,医疗支出与娱乐支出实际金额以及基本消费、储蓄和保险(占总消费的百分比)的关联仍然显著。
本研究提供了台湾疾病状况和医疗支出分布的最新描述。研究结果大多为阳性,即疾病和医疗支出与其他消费类别没有显著关联。这一观察结果与其他一些亚洲国家的观察结果不同,这可以用台湾较高的经济地位和全民基本健康保险覆盖来解释。