Comparing the economic burden of ischemic stroke patients with and without atrial fibrillation: a retrospective study in Beijing, China

Wen, L; Wu, Jingjing; Lin, Feng; Li, Yang; Qian, Feng

doi:10.1080/03007995.2017.1348345

Cited by 12 publications

(4 citation statements)

References 29 publications

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“…The UEBMI scheme covers more male inpatients while the URBMI scheme covers more female inpatients. Males have a higher probability of having stroke and incur higher healthcare costs than females (55,56). Regarding age, younger stroke patients had higher hospitalization costs in the URBMI subgroup, since URBMI was targeted at children, students and the non-working young, a result consistent with previous studies (57,58).…”

Section: Composition Of Average Total Hospitalization Costssupporting

confidence: 87%

Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance

Yang

Man

Nicholas

et al. 2020

Preprint

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Background: As the second most common cause of death globally, strokes impose a significant financial burden on patients and a country’s health system. This study demonstrates the disparities in the utilization of inpatient health services for stroke patients covered by different urban basic health insurance schemes in China.Methods: We conducted statistical analysis based on the data containing urban employee-based basic medical insurance scheme (UEBMI) and urban resident-based basic medical insurance scheme (URBMI) groups, supplied by the China Health Insurance Research Association (CHIRA). Descriptive analysis was the main method to finish this study.Results: Of the inpatients (N=56485) who had been diagnosed with ischemic stroke, extracted from the CHIRA claimed database, 64.6% (36487) were covered by UEBMI and 35.4% (19998) were covered by URBMI. The annual frequency of hospitalization of UEBMI subgroup was 1.21 times and 1.15 times for URBMI subgroup. The average length of stay of UEBMI subgroup(13.93days) was longer than URBMI subgroup (10.82 days). The UEBMI group had higher hospitalization costs but fewer out-of-pocket costs: for the UEBMI subgroup, the average hospitalization cost was RMB11187.64($1724.02), the average total out-of-pocket costs was RMB2646.42($407.81). While for the URBMI subgroup, the average hospitalization cost was RMB6402.27($986.59) and the average total out-of-pocket costs was RMB2746.10($423.17). All the above differences were significant(P<0.001). Meanwhile, patients with UEBMI had higher reimbursement rate (82.65% and 63.82%) and lower self-paid ratio (23.65% and 42.89%).Conclusions: We found that there were nonnegligible disparities in the utilization of inpatient health services between UEBMI and URBMI. Thus, our results call for a systemic strategy to improve the fragmented social health insurance system and narrow the gap in health insurance schemes in China.

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Section: Composition Of Average Total Hospitalization Costssupporting

confidence: 87%

Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance

Yang

Man

Nicholas

et al. 2020

Preprint

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“…A meta-analysis of 102 prospective studies showed that the adjusted hazard ratios (HRs) for diabetes were 2.27 (1.95–2.65) for ischemic stroke and 1.56 (1.19–2.05) for hemorrhagic stroke [10]. China is thus on the verge of being overwhelmed by the prevalence of diabetes and stroke, which are associated with a heavy socioeconomic burden [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Cigarette Smoking Is Negatively Associated with the Prevalence of Type 2 Diabetes in Middle-Aged Men with Normal Weight but Positively Associated with Stroke in Men

Chen

Wang

et al. 2019

Journal of Diabetes Research

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Background. The prevalence of diabetes and potentially related complications, including stroke, is rapidly increasing in China. The long-term effects of lifestyle may affect glucose metabolism in the general population. Although some studies have shown an association between smoking and the risk of type 2 diabetes mellitus (T2DM), the relationship remains unclear. Furthermore, the relationship between smoking and stroke in patients with T2DM has not been fully elucidated. Objective. We investigated the influence of cigarette smoking on T2DM and stroke in China. Detailed questionnaires about smoking status and anthropometric measurement were completed by participants, and oral glucose tolerance testing (OGTT), hemoglobin A1c (HbA1c), homeostasis model assessment of IR (HOMA-IR), and blood lipids were measured. Results. In total, 8196 adults aged 40 years or older were included. We found a reduced risk of impaired glucose regulation (IGR) and T2DM in male smokers with normal weight (body mass index BMI<25 kg/m2 or waist circumference WC<90 cm) compared with nonsmokers after adjusting for age, alcohol intake, physical activity, educational level, family history of diabetes, SBP, DBP, TG, TC, HDL-C, and LDL-C. However, no significant association was detected in male current smokers with overweight/obesity or female smokers. In addition, compared with nonsmokers without T2DM, current smokers with T2DM had a significantly higher risk of stroke (odds ratio: 2.64, 95% confidence interval: 1.25–5.57; P=0.011) after adjusting for confounders. Conclusions. Smoking was negatively associated with T2DM in Chinese men of normal body weight, but no significant association was found for men with overweight/obesity or women. In addition, smoking was positively associated with nonfatal stroke, especially in patients with T2DM. Further prospective studies are needed to examine the association between smoking, diabetes, and stroke in different ethnic groups.

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“…Previous studies have shown that the treatment cost of ischaemic stroke in China is substantial. [6][7][8][9][10][11][12] Stroke-related disability also affects patients' lives in the form of absenteeism or early retirement and the need for living assistance and nursing care, 13 however, such costs are rarely reported. 10 14 In addition, no studies included patient quality of life as a potential factor in their analysis.…”

Section: Introductionmentioning

confidence: 99%

One-year direct and indirect costs of ischaemic stroke in China

Lv,

Wang,

Wang

et al. 2023

Stroke Vasc Neurol

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BackgroundThis is the first real-world study to estimate the direct costs and indirect costs of first-ever ischaemic stroke with 1-year follow-up in China, based on a nationally representative sample.MethodsPatients were chosen from 20 geographically diverse sites from the nationally representative database China National Stroke Registry-III (CNSR-III). The inclusion criteria were surviving patients who were hospitalised with first-ever ischaemic stroke from February 2017 to February 2018 (the index event); aged 18–80 during the index event; no history of other stroke types. The primary endpoints were direct medical costs, direct non-medical costs, indirect costs and total cost (ie, the sum of all cost components). Patient characteristics and clinical data were extracted from CNSR-III. Stroke-related in-hospital direct medical costs were collected from hospital electronic medical records. The patient survey collected data related to out-of-hospital direct medical costs, direct non-medical costs and indirect costs. The secondary objective was to explore clinical factors associated with cost outcomes through univariate analysis and multiple regression.ResultsThe study enrolled 520 patients. The total cost was 57 567.48 CNY, with 26 612.67 CNY direct medical costs, 2 787.56 CNY direct non-medical costs and 28 167.25 CNY indirect costs. Univariate analysis showed that longer lengths of stay during the index event, higher National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale scores were associated with higher costs in all categories. Conversely, EuroQol 5 Dimension utility scores were associated with decreased costs except direct non-medical costs. Multiple regressions showed that higher admission NIHSS scores were independently associated with higher direct medical costs, indirect costs and total cost. Higher 3-month utilities were associated with lower total cost.ConclusionThis real-world study showed substantial 1-year economic burden following first-ever ischaemic stroke in China, and that indirect costs are a non-negligible driver of costs.

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Comparing the economic burden of ischemic stroke patients with and without atrial fibrillation: a retrospective study in Beijing, China

Abstract: AF increased the use of healthcare resources, treatment cost, and economic burden in patients with IS. Therefore, prevention of cardio-embolic events in patients with AF by anticoagulants may decrease the economic burden in patients with IS.

Cited by 12 publications

References 29 publications

Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance

Disparities in the utilization of ischemic stroke inpatient services in China: the role of urban health insurance

Cigarette Smoking Is Negatively Associated with the Prevalence of Type 2 Diabetes in Middle-Aged Men with Normal Weight but Positively Associated with Stroke in Men

One-year direct and indirect costs of ischaemic stroke in China

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