The Economic Burden of Hospital Costs on Families With Type 1 Diabetes Mellitus Children: The Role of Medical Insurance in Shandong Province, China

Frontiers in Public Health

article

Siyuan Wang¹  Yawei Guo²  Elizabeth Maitland³  Stephen Nicholas⁴  Jingjie Sun⁶  Anli Leng⁷ 

[1] Faculty of Business and Economics, University of Melbourne;Taiyuan Municipal Health Commission;School of Management, University of Liverpool;Australian National Institute of Management and Commerce;Newcastle Business School, University of Newcastle;Shandong Health Commission Medical Management Service Center;School of Political Science and Public Administration, Shandong University;Center for Health Preferences Research, Shandong University

关键词: hospitalization costs;    childhood type 1 diabetes;    T1DM children;    economic burden;    medical insurance;   

DOI  :  10.3389/fpubh.2022.853306

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective This study estimates the economic burden imposed on families by comparing the hospitalization costs of T1DM children with and without medical insurance in Shandong province. Methods Our data comprised 1,348 T1DM inpatient records of patients aged 18 years or younger from the hospitalization information system of 297 general hospitals in 6 urban districts of Shandong Province. Descriptive statistics are presented and regression analyses were conducted to explore the factors associated with hospitalization costs. Results Children with medical insurance had on average total hospitalization expenditures of RMB5,833.48 (US$824.02) and a hospitalization stay of 7.49 days, compared with the children without medical insurance who had lower hospitalization expenditures of RMB4,021.45 (US$568.06) and an average stay of 6.05 days. Out-of-pocket expenses for insured children were RMB3,036.22 (US$428.89), which is significantly lower than that of the uninsured children ( P < 0.01). Out-of-pocket (OOP) expenditures accounted for 6% of the annual household income of insured middle-income families, but rose to a significant 25% of the annual income for low-income families. These OOP expenditures imposed a heavy economic burden on families, with some families experiencing long-term financial distress. Both insured and uninsured families, especially low-income families, could be tipped into poverty by hospitalization costs. Conclusion Hospitalization costs imposed a significant economic burden on families with children with T1DM, especially low-income insured and uninsured families. The significantly higher hospitalization expenses of insured T1DM children, such as longer hospitalization stays, more expensive treatments and more drugs, may reflect both excess treatment demands by parents and over-servicing by hospitals; lower OOP expenses for uninsured children may reflect uninsured children from low-income families forgoing appropriate medical treatment. Hospital insurance reform is recommended.

【 授权许可】

CC BY