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Comparison of health service use and costs in stroke with and without comorbidities: a cross-sectional analysis using China urban medical claims data.

Abstract：

OBJECTIVES:Stroke is the leading cause of death and disability in China, but there is scare of evidence on whether and to what extent comorbidity affects the stroke-related costs in health system. We examined the association between comorbidity and stroke-related health service utilisation and costs in urban China. SETTINGS:The data used in this study were extracted by a 5% random sampling from claims data of China Urban Employees' Basic Medical Insurance and Urban Residents' Basic Medical Insurance from 2013 to 2016, which covered more than 93% of residents in urban China. The data included 89 cities and contained beneficiaries' demographic information, medical diagnoses and expenditures of outpatient and inpatients services. PARTICIPANTS:382 906 patients with stroke were identified as the study population in this study. PRIMARY AND SECONDARY OUTCOME MEASURES:The information on health service utilisation and cost was extracted based on the condition that stroke was claimed as the index disease. RESULTS:Among 382 906 patients with stroke, 41.0% had a comorbidity. The estimated number of annual outpatient visits among patients with 0, 1, 2 and 3 or more comorbidities were 1.97, 2.30, 2.34 and 2.37, respectively. The annual outpatient expenditure increased from 762.4 (95% CI 746.9 to 777.8) RMB among patients without any comorbidities to 1156.4 (1132.7 to 1180.2) RMB among patients with three or more comorbidities. The increased utilisation and costs among patients with comorbidity were also observed for inpatient services. Stroke-related services utilisation and costs were significantly increased among patients who comorbid conditions like hypertension or chronic pulmonary diseases. CONCLUSION:Comorbidity among patients with stroke was associated with increased healthcare utilisation and cost. It poses an extra substantial healthcare burden in China. Our study provides information for both clinical management and health service planning and financing for patients with stroke.

journal_name

BMJ Open

journal_title

BMJ open

authors

Ding R,Zhu D,Ma Y,Shi X,He P

doi

10.1136/bmjopen-2020-037032

subject

Has Abstract

pub_date

2020-12-10 00:00:00

pages

e037032

issue

12

issn

2044-6055

pii

bmjopen-2020-037032

journal_volume

10

pub_type

杂志文章

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