Department of Epidemiology and Health Statistics, Faculty of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
J Racial Ethn Health Disparities. 2018 Dec;5(6):1381-1388. doi: 10.1007/s40615-018-0488-8. Epub 2018 Mar 29.
The incidence of type 2 diabetes mellitus (T2DM) and its complications has been increasing worldwide with an increasing provision of long-term medications and health services. This study aimed to assess the healthcare costs for T2DM patients for vulnerable ethnic minority.
A cross-sectional study was conducted from October 13, 2016, to June 19, 2017, in two public hospitals in Ningxia, China. Eligible Hui and Han inpatients were recruited and interviewed. Ethnic disparities in annual healthcare expenditures for T2DM measured from a societal perspective and its associations of expenditures with other factors were analyzed by linear and quantile regressions.
Ethnic disparities in annual healthcare expenditures for T2DM were demonstrated, mainly reflecting differences in the cost of productivity loss. The quantile of annual healthcare expenditure showed significant ethnic disparities in T2DM patients with complications. At the 10th to 50th quantiles of healthcare expenditures, Hui patients had significantly lower expenditures than Han patients in both unadjusted and adjusted models. Non-significant difference in expenditures between Hui and Han patients was found at the 90th quantile of expenditure in the unadjusted model, but significantly higher expenditures for Hui patients were shown when adjusted for socioeconomic and clinical factors.
T2DM Hui patients faced significantly higher expenditures than Han patients when the costs of healthcare were high. Appropriate national policy considering the issue of ethnic minority should be further explored to improve health and subsidize economic burden for T2DM patients.
随着长期药物和医疗服务的提供增加，全球 2 型糖尿病（T2DM）及其并发症的发病率不断上升。本研究旨在评估少数民族弱势群体 T2DM 患者的医疗保健费用。
本研究于 2016 年 10 月 13 日至 2017 年 6 月 19 日在宁夏的两家公立医院进行了一项横断面研究。纳入并采访了符合条件的回族和汉族住院患者。从社会角度分析 T2DM 年度医疗支出的种族差异及其与其他因素的支出关系，采用线性和分位数回归进行分析。
研究表明，T2DM 年度医疗支出存在种族差异，主要反映在生产力损失成本上的差异。在 T2DM 伴有并发症的患者中，年度医疗支出的分位数显示出显著的种族差异。在未经调整和调整模型中，回族患者在医疗支出的第 10 至 50 分位数的支出明显低于汉族患者。在未经调整模型中，支出的第 90 分位数处，回族和汉族患者之间的支出无显著差异，但在调整社会经济和临床因素后，回族患者的支出明显更高。
当医疗保健费用较高时，T2DM 回族患者面临的支出明显高于汉族患者。应进一步探讨适当的国家政策，考虑少数民族问题，以改善少数民族患者的健康状况并减轻其经济负担。
