AI Article Synopsis
- - This study examines how different health insurance plans in China affect end-of-life (EOL) care for cancer patients, specifically looking at their outpatient and emergency visits, hospital stays, ICU admissions, costs, and where they die in their last six months.
- - Researchers analyzed data from 398 cancer patients who died between July 2015 and June 2017 in urban Yichang, using descriptive stats and regression models to compare how various insurance types influence healthcare utilization and expenses.
- - Findings showed that patients with Urban Employee Basic Medical Insurance (UEBMI) had more emergency visits and hospitalizations than those with other insurance types, like the Urban Resident-based Basic Medical Insurance (URBMI) or New Rural Cooperative Medical Scheme (
Article Abstract
Background: Disparities in the utilization, expenditures, and quality of care by insurance types have been well documented. Such comparisons have yet to be investigated in end-of-life (EOL) settings in China, where public insurance covers over 95% of the Chinese population. This study examined the associations between health insurance and EOL care in the last six months of life: outpatient visits, emergency department (ED) visits, inpatient services, intensive care unit (ICU) admissions, expenditures, and place of death among the cancer patients.
Methods: A total of 398 patients diagnosed with cancer who survived more than 6 months after diagnosis and died from July 2015 to June 2017 in urban Yichang, China, were included. Descriptive analysis and multivariate regression models were used to investigate the bivariate and independent associations, respectively, between health insurance with EOL healthcare utilization, expenditures and place of death.
Results: Urban Employee Basic Medical Insurance (UEBMI) beneficiaries visited EDs more frequently than Urban Resident-based Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS) beneficiaries (marginal effects [95% Confidence Interval]: 2.15 [1.81-2.48] and 1.92 [1.59-2.26], respectively). NRCMS and UEBMI beneficiaries had more hospitalizations than URBMI beneficiaries (1.01 [0.38-1.64] and 0.71 [0.20-1.22], respectively). Compared to URBMI beneficiaries, NRCMS beneficiaries and UEBMI beneficiaries had ¥15,722 and ¥43,241 higher expenditures. Similarly, UEBMI beneficiaries were most likely to die in hospitals, followed by NRCMS (UEBMI vs. NRCMS: 0.23 [0.11-0.36]) and URBMI (UEBMI vs. URBMI: 0.67 [0.57-0.78]) beneficiaries.
Conclusions: The disproportionately lower utilization of EOL care among NRCMS and URBMI beneficiaries, compared to UEBMI beneficiaries, raised concerns regarding quality of EOL care and financial burdens of NRCMS and URBMI beneficiaries. Purposive hospice care intervention might be warranted to address EOL care for these beneficiaries in China.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650520 | PMC |
| http://dx.doi.org/10.1186/s12889-020-09463-1 | DOI Listing |
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Article Synopsis
- - This study examines how different health insurance plans in China affect end-of-life (EOL) care for cancer patients, specifically looking at their outpatient and emergency visits, hospital stays, ICU admissions, costs, and where they die in their last six months.
- - Researchers analyzed data from 398 cancer patients who died between July 2015 and June 2017 in urban Yichang, using descriptive stats and regression models to compare how various insurance types influence healthcare utilization and expenses.
- - Findings showed that patients with Urban Employee Basic Medical Insurance (UEBMI) had more emergency visits and hospitalizations than those with other insurance types, like the Urban Resident-based Basic Medical Insurance (URBMI) or New Rural Cooperative Medical Scheme (
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