Distribution of Illness and Medical Expenditure: A Survey in Two Villages in Rural Beijing

Abstract

BackgroundThe main goal of this study is to examine the distributions of illness conditions and resulting medical expenditures and their associated factors. To achieve this goal, an in-house survey was conducted in August of 2012 in rural Beijing, the capital city of China.ResultsThe survey was conducted in Nanjianchang and Beijianchang, which are two villages 20 KM away from Miyun, a satellite city of Beijing. Data was collected on 346 households, which included 834 members. Variables measured included household characteristics, household head characteristics, illness conditions, and medical expenditures. Illness conditions and corresponding expenditure were measured for inpatient treatment, outpatient treatment, and self-treatment separately. Multivariate analysis suggested that the presence of inpatient treatment was associated with household head characteristics including age, gender, and education. The presence of a high level of outpatient treatment was associated with household head characteristics including gender and education. The presence of a high level of self-treatment was significantly associated with household size. In the analysis of overall out-of-pocket (OOP) medical expenditure, only age of household head was borderline significant. In the analysis of OOP inpatient expenditure, age and gender of household head were borderline significant. The OOP outpatient expenditure was associated with household size, presence of members older than 60, household head's gender, marital status, and occupation. The OOP self-treatment expenditure was not associated with any household characteristic.ConclusionsFor the surveyed households, medical expenditure made up a considerable proportion of the total consumption. This study suggested that the presence of illness conditions and resulting OOP medical expenditure were associated with certain household and household head characteristics. Such results may help identify the subgroup that is the most affected by illness conditions. As this study collected recent data on inpatient, outpatient, and self-treatment separately, it may provide a useful complement to the existing studies.

Observations on the Prevalence, Characteristics, and Effects of Self-Treatment

“…In this study, self-treatment was defined as taking drugs and/or other home remedies or having a massage and/or physiotherapy, when experiencing symptoms during a period of 2 weeks prior to survey. In a survey study conducted in Miyun, a satellite city of Beijing, China, in 2012, out of 346 households, 75 had more than 5 episodes of self-treatments per person within 12 months ( 7 , 12 ). In a survey conducted in Iran on weld workers ( 27 ), 90% stated a preference for self-treatment, 84.5% had used folk treatments, and 90% of the drugs used came from the stock of home pharmacies.…”

“…Prevalence can vary across regions. It has been demonstrated that self-medication in rural areas is common ( 62 ), and a lot of studies have focused on rural areas ( 7 , 33 , 63 ). A national survey study conducted in China over a period of 4 years showed that prevalence was higher in urban areas than in rural China ( 2 ).…”

“…Second, although self-treatment has low cost per episode, it can result in considerable financial burden, because of its high frequency, and because the cost of self-treatment is usually poorly covered by insurance. For example, a recent study conducted in rural Beijing, China, reported that self-treatment expense accounted for 8% of the total per capita expense, almost as expensive as inpatient treatment ( 7 ). Third, studies have observed that, without the involvement of trained professionals, the effects of self-treatment have been mostly self-evaluated ( 8 , 9 ), which may pose a public health concern.…”

Descriptions of self-treatment for the middle-aged and elderly in Shanxi, China

“…In recent years, medical expenditures [ 18 – 22 ] and health insurance [ 21 , 23 – 26 ], which are closely linked in patients’ vital interests, together with associated factors, have been important topics in many studies. In 2012, a survey which was conducted in two villages in Beijing observed a positive association between out-of-pocket (OOP) medical expenditures and age [ 19 ]. Other studies on healthcare expenditure showed that household income, the presence of chronic disease [ 20 ] and the usage of insurance [ 21 ] [ 23 ] had significant influence on healthcare expenditure.…”

Applying GRA to analyze influencing factors of patients’ financial burden

“…Wang et al , 2015; Q. Wang et al , 2015), loss of a spouse (Rolden et al , 2014), distribution of illness conditions (Song et al , 2013) and out-of-pocket spending caps (Abramowitz and O’Hara, 2015; Riggs et al , 2015).…”