Use of Traditional Chinese Medicine and Its Impact on Medical Cost among Urban Ischemic Stroke Inpatients in China: A National Cross-Sectional Study

Huang, Zhengwei; Shi, Xuefeng; Nicholas, Stephen; Maitland, Elizabeth; Yang, Yong; Zhao, Weihan; Ma, Yong; Jiang, Yan

doi:10.1155/2021/8554829

Cited by 7 publications

(7 citation statements)

References 44 publications

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“…However, our study using medical insurance data for lung cancer in mainland China did not find similar findings. We found that the total inpatient cost of TCM users was higher than those of TCM nonusers controlling for demographic characteristics, a finding consistent with the study by Huang et al for ischemic stroke [ 23 ]. This seems to be contrary to previous research that demonstrated CAM was generally cheaper than conventional medication, and that the use of CAM could reduce the economic burden of disease [ 24 , 25 ].…”

Section: Discussionsupporting

confidence: 91%

Costs of traditional Chinese medicine treatment for inpatients with lung cancer in China: a national study

Nie

Han

Nicholas

et al. 2023

BMC Complement Med Ther

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Background Traditional Chinese Medicine (TCM) has long been a widely recognized medical approach and has been covered by China’s basic medical insurance schemes to treat lung cancer. But there was a lack of nationwide research to illustrate the impact of the use of TCM on lung cancer patients’ economic burden in mainland China. Therefore, we conduct a nationwide study to reveal whether the use of TCM could increase or decrease the medical expenditure of lung cancer inpatients in mainland China. Methods This is a 7-year cross-sectional study from 2010 to 2016. The data is a random sample of 5% from lung cancer claims data records of Chinese Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI). Mann-Whitney test was used to compare inpatient cost data with positive skewness. Ordinary least squares regression analysis was performed to compare the total TCM users’ hospitalization cost with TCM nonusers’, to examine whether TCM use is the key factor inducing relatively high medical expenditure. Result A total of 47,393 lung cancer inpatients were included in this study, with 38,697 (81.7%) of them at least using one kind of TCM approach. The per inpatient medical cost of TCM users was RMB18,798 (USD2,830), which was 65.2% significantly higher than that of TCM nonusers (P < 0.001). The medication cost, conventional medication cost, and nonpharmacy cost of TCM users were all higher than TCM nonusers, illustrating the higher medical cost of TCM users was not induced by TCM only. With confounding factors fixed, there was a positive correlation between TCM cost and conventional medication cost, nonpharmacy cost (Coef. = 0.283 and 0.211, all P < 0.001), indicting synchronous increase of TCM costs and conventional medication cost for TCM users. Conclusion The use of TCM could not offset the utilization of conventional medicine, demonstrating TCM mainly played a complementary role but not an alternative role in the inpatient treatment of lung cancer. A joint Clinical Guideline that could balance the use of TCM and Conventional medicine should be developed for the purpose of reducing economic burden for lung cancer inpatients.

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Section: Discussionsupporting

confidence: 91%

Costs of traditional Chinese medicine treatment for inpatients with lung cancer in China: a national study

Nie

Han

Nicholas

et al. 2023

BMC Complement Med Ther

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“…This is consistent with the results of previous studies. Huang et al concluded that medical costs for hospitalized TCM users were 32.5% higher than for TCM nonusers, and that the cost of TCM increased significantly with increasing prescriptions of conventional medicine, which suggesting that TCM treatments were complements, rather than substitutes, to conventional treatment [ 22 ]. Nie et al concluded that medication costs, conventional medication costs and nonpharmacy costs for TCM users were higher than for TCM nonusers, revealing that the higher medical costs for TCM users were not just to do with TCM treatments [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Liao et al, using Taiwan’s 2005 Longitudinal Health Insurance Database, found that the TCM insurance cost was consistently lower than those covering biomedicine in patients with liver cancer [ 17 ]. Huang et al concluded that TCM mainly played a complementary role to conventional medicine in the treatment of Chinese mainland ischemic stroke [ 22 ]. The above researches demonstrated the influence of TCM using either on treatment effect or on the economic burdens of other diseases.…”

Section: Introductionmentioning

confidence: 99%

Differences in medical costs between TCM users and TCM nonusers in inpatients with thalassemia

Han

Nie

Huang

et al. 2023

BMC Health Serv Res

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Background Thalassemia has brought serious health threats and economic burdens to patients worldwide. There is no sovereign remedy for thalassemia, both conventional and Traditional Medicine (TM) methods have certain effects on this disease. As typical of TM, Traditional Chinese Medicine (TCM) has been widely used in the treatment of thalassemia. Previous studies mainly focused on conventional treatments for thalassemia and patients’ medical burden, but no research has examined the effects of TCM use on the economic burdens for thalassemia inpatients in mainland China. The main objective of this study is to compare the medical cost differences between TCM users and TCM nonusers, furtherly, we will discuss the role of TCM use in the treatment of thalassemia. Methods We employed the 2010–2016 Medicare claims database provided by the China Health Insurance Research Association (CHIRA). Chi-square and Mann-Whitney tests were used to analyze the differences between TCM users and TCM nonusers. Multiple regression analysis was performed using the ordinary least squares method to compare the TCM users’ inpatient medical cost with TCM nonusers’, and to further examine the correlation between TCM cost, conventional medication cost and nonpharmacy cost for TCM users. Results A total of 588 urban thalassemia inpatients were identified, including 222 TCM users and 366 TCM nonusers. The inpatient medical cost of TCM users was RMB10,048 (USD1,513), which was significantly higher than TCM nonusers (RMB1,816 (USD273)). Total inpatient cost for TCM users was 67.4% higher than those of TCM nonusers (P < 0.001). With confounding factors fixed, we found that the conventional medication cost and nonpharmacy cost were positively correlated with TCM cost. Conclusion Total hospitalization expenses for TCM users were higher than TCM nonusers. Both the conventional medication cost and nonpharmacy cost of TCM users were all higher than TCM nonusers. We infer TCM plays a complementary role, rather than an alternative, in the treatment of thalassemia due to the lack of cooperative treatment guidelines. It is recommended that a cooperative diagnosis and treatment guidelines should be generated to balance the use of TCM and conventional medicine for treating thalassemia, so as to reduce the economic burdens on patients.

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“…However, the relationship and underlying mechanism between the risk factors and inpatient costs of stroke have not been given attention in the last 10 years [ 11 ]. Most current studies have focused on the prevalence and disease burden of stroke and its attributing risk factors [ 12 ]. Therefore, this study aimed to explore the relationship between risk factors and stroke-related inpatient costs.…”

Section: Introductionmentioning

confidence: 99%

How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay

Cao,

Li,

Tang

et al. 2024

BMC Geriatr

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Background As stroke has become the leading cause of death and disability in China, it has induced a heavy disease burden on society, families, and patients. Despite much attention within the literature, the effect of multiple risk factors on length of stay (LOS) and inpatient costs in China is still not fully understood. Aim To analyse the association between the number of risk factors combined and inpatient costs among adults with stroke and explore the mediating effect of LOS on inpatient costs. Methods A retrospective cross-sectional study was conducted among stroke patients in a tertiary hospital in Nantong City from January 2018 to December 2019. Lifestyle factors (smoking status, exercise), personal disease history (overweight, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation), family history of stroke, and demographic characteristics were interviewed by trained nurses. Inpatient costs and LOS were extracted from electronic medical records. Hierarchical multiple linear regression models and mediation analysis were used to examine the direct and indirect effects of the number of risk factors combined for stroke on inpatient costs. Results A total of 620 individuals were included, comprising 391 ischaemic stroke patients and 229 haemorrhagic stroke patients, and the mean age was 63.2 years, with 60.32% being male. The overall mean cost for stroke inpatients was 30730.78 CNY ($ 4444.91), and the average length of stay (LOS) was 12.50 days. Mediation analysis indicated that the greater number of risk factors was not only directly related to higher inpatient costs (direct effect = 0.16, 95%CI:[0.11,0.22]), but also indirectly associated with inpatient cost through longer LOS (indirect effect = 0.08, 95% CI: [0.04,0.11]). Furthermore, patients with high risk of stroke had longer LOS than those in low-risk patients, which in turn led to heavier hospitalization expenses. Conclusions Both the greater number of risk factors and high-risk rating among stroke patients increased the length of stay and inpatient costs. Preventing and controlling risk behaviors of stroke should be strengthened.

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Use of Traditional Chinese Medicine and Its Impact on Medical Cost among Urban Ischemic Stroke Inpatients in China: A National Cross-Sectional Study

Cited by 7 publications

References 44 publications

Costs of traditional Chinese medicine treatment for inpatients with lung cancer in China: a national study

Costs of traditional Chinese medicine treatment for inpatients with lung cancer in China: a national study

Differences in medical costs between TCM users and TCM nonusers in inpatients with thalassemia

How health risk factors affect inpatient costs among adults with stroke in China: the mediating role of length of stay

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