Abstract. Experimental data imply that serum C-reactive protein (CRP) is a marker of general systemic inflammation, and inflammation may have a role in the development of pneumonia. The aim of the present study was to investigate the associations of serum CRP levels in infant patients with pneumonia by meta-analysis. The Science Citation Index, Cochrane Library, PubMed, Embase, CINAHL, Current Contents and two Chinese (CMB and CNKI) databases were searched. Studies were pooled and standard mean difference (SMD) and the corresponding 95% confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted. The statistical analysis was conducted using Stata software version 12.0. Serum CRP levels were analyzed in 10 clinical case-control studies (652 infants with pneumonia and 845 healthy controls); significant differences in serum CRP levels were observed between infants with pneumonia and the healthy controls (SMD=4.41, 95% CI: 3.34-5.47, P<0.001). Ethnicity-stratified subgroup analysis detected that high levels of serum CRP may be the main risk factor for infant pneumonia in Asian, African and Caucasian populations (all P<0.05). Serum CRP levels were statistically higher in infants with pneumonia than in healthy infants, and thus serum levels of CRP may have independent diagnostic value for pneumonia in children.
Background: Hypertension is a prevalent and costly health condition in China. Little is known about variation of the inpatient and outpatient expenditures attributable to hypertension between prefecture-level administrative regions (PARs) and the drivers of such variation among China’s middle-aged and elderly population. Methods: We obtain data from China Health and Retirement Longitudinal Survey between 2011 and 2015, panel tobit models were used in our study to estimate differences across 122 PARs. Expenditure variation was explained by the characteristics of individuals and regions, including measures of healthcare supply. Results: The cost of treatment for patients with hypertension varies greatly geographically, with the highest outpatient and inpatient costs being 77 and 102 times the lowest, respectively. After adjustment for the individual and PAR character, there are associations between expenditure and region bed density. Conclusion: There were significant regional differences in the outpatient and inpatient costs of middle-aged and elderly patients with hypertension in China, the difference between individuals may be an important reason, which has little to do with regional economic development differences, but is related to regional bed density.
Background: The prevention and control of hypertension should be an effective way to reduce deaths and it has been a high priority in China. The Chinese government issued the National Essential Public Health Services Package (NEPHSP) in 2009; this initiative provides free public health services to meet the challenges posed by hypertension. It includes health education, regular health checkups, and regular follow-ups provided to patients with hypertension aged ≥ 35. This study explored the influence of the NEPHSP on outpatient and inpatient expenditure among patients with hypertension. Methods: Data were mined from the 2011–2015 Harmonized China Health and Retirement Longitudinal Study. The dependent variables were the outpatient and inpatient expenditure of patients with hypertension. The independent variable was defined as whether covered by the NEPHSP in 2013 or 2015. Using propensity score matching (PSM) to match the individual characteristics of hypertension in the NEPHSP-covered group and the NEPHSP-uncovered group, Tobit regression models with difference-in-differences (DID) were used to analyze the outcomes. Results: After PSM, of the 1,956 hypertensive participants, 369 had physical exams covered by the NEPHSP in 2013 and 2015. In 2013 and 2015, the outpatient and inpatient expenses of patients with hypertension increased compared with 2011. A DID estimate for the NEPHSP-covered service was associated with a marginal significant decrease of RMB 319.79 (p = 0.586) and RMB 1072.02 (p = 0.068) in hypertension inpatient expected expenditure in 2013 and 2015, respectively. The DID estimate showed no significant change among outpatient expected expenditure. Conclusions: The NEPHSP may reduce inpatient expenditure among patients with hypertension. Further strengthening of the NEPHSP may reduce their burden.
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