Sun Xian, Liabsuetrakul Tippawan, Xie Xiaomin, Liu Ping
Department of Epidemiology and Health Statistics, Faculty of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Medicine (Baltimore). 2019 Sep;98(39):e17376. doi: 10.1097/MD.0000000000017376.
This study aimed to compare the catastrophic health expenditure (CHE) and impoverishment of type 2 diabetes mellitus (T2DM) patients between 2 ethnic groups and explore the contribution of associated factors to ethnic differences in CHE and impoverishment in Ningxia Hui Autonomous Region, China.A cross-sectional study was conducted in 2 public hospitals from October 2016 to June 2017. Data were collected by interviewing eligible Hui and Han T2DM inpatients and reviewing the hospital electronic records. Both CHE and impoverishment were measured by headcount and gap. The contributions of associated factors to ethnic differences were analyzed by the Blinder-Oaxaca decomposition technique.Both the CHE and impoverishment of Hui patients before and after reimbursement were significantly higher than those of Han patients. The ethnic differences in CHE and impoverishment headcount after reimbursement were 11.9% and 9.8%, respectively. The different distributions of associated factors between Hui and Han patients contributed to 60.5% and 35.7% of ethnic differences in CHE and impoverishment, respectively. Household income, occupation, and region were significant contributing factors.Hui T2DM patients suffered greater CHE and impoverishment than Han patients regardless of reimbursements from health insurance. Differences in socioeconomic status between Hui and Han patients were the main factors behind the ethnic differences.
本研究旨在比较两个民族2型糖尿病（T2DM）患者的灾难性卫生支出（CHE）和贫困情况，并探讨相关因素对中国宁夏回族自治区CHE和贫困的民族差异的影响。2016年10月至2017年6月在两家公立医院开展了一项横断面研究。通过对符合条件的回族和汉族T2DM住院患者进行访谈并查阅医院电子记录来收集数据。CHE和贫困均通过人头数和差距来衡量。采用布林德-奥萨克分解技术分析相关因素对民族差异的影响。回族患者报销前后的CHE和贫困程度均显著高于汉族患者。报销后CHE和贫困人头数的民族差异分别为11.9%和9.8%。回族和汉族患者相关因素的不同分布分别导致CHE和贫困民族差异的60.5%和35.7%。家庭收入、职业和地区是重要的影响因素。无论医疗保险报销情况如何，回族T2DM患者比汉族患者遭受更大的CHE和贫困。回族和汉族患者社会经济地位的差异是民族差异背后的主要因素。
