Catastrophic health expenditure on acute coronary events in Asia: a prospective study.
Catastrophic health expenditure on acute coronary events in Asia: a prospective study.
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DOI：
10.2471/blt.15.158303
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发表时间：
2016-03-01
影响因子：
11.1
通讯作者：
Huo Y
中科院分区：
文献类型：
--
作者：
Jan S;Lee SW;Sawhney JP;Ong TK;Chin CT;Kim HS;Krittayaphong R;Nhan VT;Itoh Y;Huo Y
估算亚洲急性冠脉综合征住院患者的自付费用和灾难性医疗支出的发生率。 2011 年 6 月至 2012 年 5 月期间，参与者在中国、印度、马来西亚、韩国、新加坡、泰国和越南参加了这项观察性研究。各研究中心必须连续招募至少 10 名因急性冠状动脉综合征住院的参与者。灾难性医疗支出被定义为首次住院的自付费用> 家庭年收入的30%，并在出院后六周进行评估。我们使用逻辑回归模型评估了健康支出与参与者的年龄、性别、冠状动脉事件诊断和健康保险状况之间的关联。在 12,922 名参与者中，9370 名 (73%) 拥有完整的支出数据。平均自付费用为 3237 美元。没有保险的人中有 66% (1984/3007) 报告了灾难性的医疗支出，而有健康保险的人则有 52% (3296/6366) (P<0.05)。灾难性支出的发生率从中国无保险参与者的 80% (1055/1327) 和已投保参与者的 56% (3212/5692) 到马来西亚的 0% (0/41) 不等。亚洲地区因急性冠状动脉综合征住院而导致的灾难性医疗支出存在很大差异。尽管保险提供了一些保护，但仍有大量拥有健康保险的人遭受了财务灾难。
To estimate out-of-pocket costs and the incidence of catastrophic health expenditure in people admitted to hospital with acute coronary syndromes in Asia. Participants were enrolled between June 2011 and May 2012 into this observational study in China, India, Malaysia, Republic of Korea, Singapore, Thailand and Viet Nam. Sites were required to enrol a minimum of 10 consecutive participants who had been hospitalized for an acute coronary syndrome. Catastrophic health expenditure was defined as out-of-pocket costs of initial hospitalization > 30% of annual baseline household income, and it was assessed six weeks after discharge. We assessed associations between health expenditure and age, sex, diagnosis of the index coronary event and health insurance status of the participant, using logistic regression models. Of 12 922 participants, 9370 (73%) had complete data on expenditure. The mean out-of-pocket cost was 3237 United States dollars. Catastrophic health expenditure was reported by 66% (1984/3007) of those without insurance versus 52% (3296/6366) of those with health insurance (P < 0.05). The occurrence of catastrophic expenditure ranged from 80% (1055/1327) in uninsured and 56% (3212/5692) of insured participants in China, to 0% (0/41) in Malaysia. Large variation exists across Asia in catastrophic health expenditure resulting from hospitalization for acute coronary syndromes. While insurance offers some protection, substantial numbers of people with health insurance still incur financial catastrophe.