Faculty of Business and Economics, University of Melbourne, Melbourne, VIC, Australia.
Taiyuan Municipal Health Commission, Taiyuan, China.
Front Public Health. 2022 May 6;10:853306. doi: 10.3389/fpubh.2022.853306. eCollection 2022.
This study estimates the economic burden imposed on families by comparing the hospitalization costs of T1DM children with and without medical insurance in Shandong province.
Our data comprised 1,348 T1DM inpatient records of patients aged 18 years or younger from the hospitalization information system of 297 general hospitals in 6 urban districts of Shandong Province. Descriptive statistics are presented and regression analyses were conducted to explore the factors associated with hospitalization costs.
Children with medical insurance had on average total hospitalization expenditures of RMB5,833.48 (US$824.02) and a hospitalization stay of 7.49 days, compared with the children without medical insurance who had lower hospitalization expenditures of RMB4,021.45 (US$568.06) and an average stay of 6.05 days. Out-of-pocket expenses for insured children were RMB3,036.22 (US$428.89), which is significantly lower than that of the uninsured children ( < 0.01). Out-of-pocket (OOP) expenditures accounted for 6% of the annual household income of insured middle-income families, but rose to a significant 25% of the annual income for low-income families. These OOP expenditures imposed a heavy economic burden on families, with some families experiencing long-term financial distress. Both insured and uninsured families, especially low-income families, could be tipped into poverty by hospitalization costs.
Hospitalization costs imposed a significant economic burden on families with children with T1DM, especially low-income insured and uninsured families. The significantly higher hospitalization expenses of insured T1DM children, such as longer hospitalization stays, more expensive treatments and more drugs, may reflect both excess treatment demands by parents and over-servicing by hospitals; lower OOP expenses for uninsured children may reflect uninsured children from low-income families forgoing appropriate medical treatment. Hospital insurance reform is recommended.
本研究通过比较山东省有和无医疗保险的 T1DM 患儿的住院费用，估算家庭所承受的经济负担。
我们的数据来自山东省 6 个城区 297 家综合医院住院信息系统的 1348 例 18 岁以下 T1DM 住院患者记录。采用描述性统计和回归分析方法，探讨与住院费用相关的因素。
有医疗保险的患儿平均总住院支出为 5833.48 元人民币（824.02 美元），住院天数为 7.49 天，而无医疗保险的患儿住院支出为 4021.45 元人民币（568.06 美元），平均住院天数为 6.05 天。有医疗保险患儿的自付费用为 3036.22 元人民币（428.89 美元），明显低于无医疗保险患儿（<0.01）。有医疗保险的中等收入家庭自付费用占家庭年收入的 6%，但对低收入家庭而言，这一比例显著上升至 25%。这些自付费用给家庭带来了沉重的经济负担，一些家庭长期陷入财务困境。有医疗保险和无医疗保险的家庭，尤其是低收入家庭，都可能因住院费用而陷入贫困。
T1DM 患儿的住院费用给家庭带来了显著的经济负担，尤其是低收入有医疗保险和无医疗保险的家庭。有医疗保险的 T1DM 患儿的住院费用显著较高，如住院时间延长、治疗和药物费用增加，这可能反映了家长的过度治疗需求和医院的过度服务；无医疗保险患儿的自付费用较低，可能反映了来自低收入家庭的无保险患儿放弃了适当的医疗。建议进行医疗保险改革。
