ABSTRACT
OBJECTIVE：To e xplore the health economic burden of hypertension patients at county-level areas and its influential factors in China. METHODS ：A questionnaire survey was conducted on hypertension patients in 7 county-level public hospitals from 6 provinces as Hebei ，Shandong，Shanxi provinces by using a convenient sampling method. Catastrophic health expenditure was defined by the standard of “medical and health expenditure exceeding 10％ of household income ”. The incidence ， average gap and relative gap of catastrophic health expenditure were analyzed. A multi-factor Logistic regression model analysis was used to analyze the influential factors that lead to catastrophi c health expenditure. RESULTS ：A total of 1 378 questionnaires were sent out ，and 925 valid questionnaires were collected with effective rate of 67.13％ . The incidence of catastrophic health expenditure，average gap and relative gap among hypertension patients were 23.03％，19.37％ and 84.12％，respectively. At different income levels ，the incidence of catastrophic health expenditure，average gap and relative gap were 72.67％ ， 96.79％ and 133.18％ in the poorest household group ，and were 1.94％ ，0.47％ and 24.23％ in the richest household group. Among different types of medical insurance ，the incidence of catastrophic health expenditure in patients covered by “New Rural Cooperative Medical Scheme （NRCMS）”the highest （31.30％）. The household income ，complications and the type of health insurance had significant impacts on the incidence of catastrophic health expenditure in hypertension patients （P＜0.05）. CONCLUSIONS：The incidence of catastrophic health expenditure in hypertension patients with different income levels is different. As the income level raised ，the incidence of catastrophic health expenditures continued to decrease. But the protection of household health expenditure by NRCMS is weak. It is suggested that a certain policy preference should be given to families with low income and patients with chronic diseases ，so as to ensure the rights and interests of patients with hypertension .
ABSTRACT
OBJECTIVE： To evaluate the economics of the full coverage policy for hypoglycemic essential medicines in Taizhou city， and to provide reference for improving medicine accessibility and essential medicine system in China. METHODS： The electronic health records and financial input data of diabetic patients were extracted from different districts and counties of Taizhou city during 2009-2016. In cohort study design， taking the implementation time of each district and county’s policies as the breakpoint， the data recorded annually were processed as annual data， forming the cohort data for 1 year before （baseline year） and 3 years after the implementation of the policies. According to the choice of free medicines after the implementation of the policy， they were divided into policy group and control group. Propensity score matching was used to balance the differences between two groups to get the final sample， and then the economics of the policy was evaluated with the methods of difference-in-differences. The cost and benefit of implementation policy were calculated. RESULTS： Totally 14 744 people of each group were got by propensity score matching. The mean annual financial expenses on free medicine per capita were 263.8 yuan. Compared with baseline year， mean annual medicine expenses per capita reduced by the policy were 649.2 yuan， and mean annual hospitalization expenses per capita were 624.7 yuan. Thus the input-output ratio of the policy was 1 ∶ 4.8. CONCLUSIONS： The implementation of the policy is beneficial to reduce the cost burden of patients and economical. It can be popularized and sustained through scientific design combined with relevant policies.