ObjectivesTo study the medical expenditure and influencing factors of patients with hypertension in Shanxi Province, China.DesignA cross-sectional study.Setting1088 medical institutions, including general hospitals, traditional Chinese medicine hospitals, special hospitals, basic medical institutions and public health institutions.Participants180 441 hypertensive outpatients and 14 763 inpatients from 1 January to 31 December 2017.Primary and secondary outcome measuresCurative care expenditure for hypertension (CCEht) was measured based on System of Health Accounts 2011. Influenced factors were analysed by univariate analysis and multiple layer perceptron neural network.ResultsIn 2017, CCEht was US$307.71 million, accounting for 3.63% of total CCE and 0.14% of gross domestic product (GDP) in Shanxi Province of China. CCE of hypertensive outpatients (CCEht-out) and inpatients (CCEht-in) accounted for 44.49% and 55.51% of CCEht. Drug fee accounted for 81.55% of CCEht-out and 22.50% of CCEht-in, respectively. The top three influencing factors were drug fee, surgical fee and hospitalisation days for inpatients, and drug fee, examination fee and test fee for outpatients.ConclusionsThe medical expenditure of hypertension is still heavy for individuals and society. The diagnosis and treatment capacities of primary healthcare system has been enhanced. New rural cooperation medical insurance and urban employee basic medical insurance have a trend of overusing, and the burden of family healthcare expenditure is still heavy. To ease the economic burden of patients with hypertension and improve the efficiency of social resources utilisation, policymakers should pay more attention to key groups, further increase support for primary healthcare system, standardise the treatment and reimbursement of hypertension and incline the reimbursement policy to outpatient service.
BackgroundGliomas account for over two-thirds of all malignant brain tumors and have few established risk factors beyond family history and exposure to ionizing radiation. Importantly, recent studies highlighted the exposure to ultrafine particles (UFP) as a putative risk factor for malignant brain tumors.MethodsClinical and geographic data encompassing all provinces and territories from 1992 to 2010 was obtained from the Canadian Cancer Registry and Le Registre Québécois du Cancer. Linear regression and joinpoint analyses were performed to assess incidence trends. Significantly higher and lower incidence postal codes were then interrogated using Standard Industrial Classification codes to detect significant industrial activity.ResultsIn Canada, between 1992 and 2010, there were ~32,360 cases of glioma. Of these, 17,115 (52.9%) were glioblastoma. The overall crude incidence rates of 5.45 and 2.87 cases per 100,000 individuals per year for gliomas and glioblastomas, respectively, were identified. Our findings further revealed increasing crude incidence of gliomas/glioblastomas over time. A male predominance was observed. Provinces leading in glioma incidence included Quebec, Nova Scotia, and New Brunswick. Significantly lower crude incidence of glioma was found in Nunavut, Northwest Territories, Ontario, and Alberta. A putative regional clustering of gliomas was observed, with higher incidence rates in postal code areas correlating with industrial activity related to airport operations.ConclusionThis study describes the geographic distribution of the glioma disease burden and, potentially, identifies industrial activity related to airport operations as potentially being associated with higher incidence of this cancer.
Background: Hypertension requires long-term treatment and medication, which not only affects people’s health, but also brings heavy economic burden for families and society. Therefore, it is meaningful to reveal the actual personal and socio-economic burdens of hypertension based on a tool recognized internationally to improve management of hypertensive patients and provide more information for policy makers, analysts, and international comparisons. Methods: We collected expense records of 180441 hypertensive outpatients and 14763 inpatients in Shanxi Province of China in 2017. Curative care expenditure for hypertension(CCEht) were analyzed based on System of Health Accounts 2011, and influencing factors were analyzed by multiple layer perceptron (MLP) neural network.Results: In 2017, CCEht was US$ 307.71 million, accounted for 3.63% of the total CCE and 0.14% of GDP in Shanxi Province of China. CCE of hypertensive outpatients (CCEht-out) and inpatients (CCEht-in) accounted for 44.49% and 55.51% of the CCEht, drug fee accounted for 81.55% of CCEht-out and 22.50% of CCEht-in, respectively. CCEht increased from the age of 30, and the highest occured in age 60-69. The patients with the age of 40-79 accounted for 86.49% of total CCEht. CCEht of male patients were generally higher than that of female, and there is a significant difference between CCEht for male and female in terms of age. The diagnosis and treatment capacity of primary health care system had been enhanced. New rural cooperation medical insurance and urban employee basic medical insurance had the trend of overusing, and burden of family healthcare expenditure was still very heavy. In the MLP neural network, the top three influencing factors were drug fee, surgical fee and hospitalization days for inpatients, drug fee, examination fee and test fee for outpatients. Conclusions: To ease the economic burden of hypertensive patients and improve the utilization efficiency of social resources , the policy makers should pay more attention to the hypertensive patients aging 40-79, strengthen prevention and outpatient treatment for young men and the inpatient treatment for women at older ages, further increase support for primary health care system, standardize the treatment and reimbursement of hypertension, and incline the reimbursement policy to outpatient service.
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