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Article Abstract
Background: Malaria burden is still worrisome, while empirical evidence from malaria-eliminated countries including China may provide inspiration for the world.
Objective: This study aimed to investigate China's malaria hospitalization costs and explore its determinants.
Methods: Stratified multistage sampling across provincial, municipal, and county hospitals was conducted in 2017. All the malaria medical records were retrieved from 2014 to 2016 in 70 hospitals. Parametric and non-parametric methods were employed to estimate hospitalization costs, and the non-parametric bootstrap was used to compare hospitalization costs among sample areas and assessed the uncertainty of its differences. Quantile regressions were conducted to identify the determinants of hospitalization costs.
Results: The median hospitalization costs of 1633 malaria inpatients were 628 USD. Medication and laboratory tests accounted for over 70% of total expenditure. The median reimbursement rate was 41.87%, and this number was even lower in higher-level hospitals (<35%) and among the New Rural Cooperative Medical Scheme (<40%). Finally, health insurance type, hospital tier, clinical units, unknown fever, and comorbidity were the main determinants of hospitalization costs.
Conclusion: The disparity of health protection for malaria hospitalization between rural and urban areas was noteworthy. Equivocal diagnosis and comorbidity are contributors of high cost as well. A reasonable payment system and enhanced capacities to treat malaria in a cost-effective way are suggested to reassure malaria economic burden.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651145 | PMC |
| http://dx.doi.org/10.3389/fpubh.2022.994529 | DOI Listing |
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