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OBJECTIVE@#To explore the level and influential factors for out-of-pocket (OOP) expenditure regarding Hunan Provincial Urban Employee Basic Medical Insurance (UEBMI) and to provide evidence for improvement of medical insurance payment system. @*METHODS@#Stratified random sampling method was used to obtain 10 527 records of cancer inpatients from January 2011 to December 2014. Social demographic and expenditure information were collected from UEBMI information system. The proportion of OOP expenditure for inpatient and each part of the cost was described. Multiple linear regression was used to analyze main related factors of OOP expenditure. @*RESULTS@#The median proportion of OOP for inpatients costs was 20.11%, and remained stable from 2011 to 2014. The main related factors for OOP expenditure were age, civil servant, retirment status, hospital level, cost of hospitalization, hospitalization duration, medicine cost, proportion of general medical service charges, treatment cost, expenses of examination and laboratory test, and cancer type. @*CONCLUSION@#OOP expenditure among UEBMI cancer inpatients was under control and stable. The level can well reflect the policy preferences. It could be further improved through the control of related factors, particularly the hospital level.
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Humans , Health Care Costs , Health Expenditures , Hospitalization , Economics , Inpatients , Neoplasms , EconomicsABSTRACT
Objective To compare the efficacy of α1 adrenergic receptor blocker,5α-reductase inhibitor or combination therapy in benign prostatic hyperplasia (BPH),and to explore the application of multi-level statistical model in assessment of BPH treatments.Methods Pragmatic clinical trials (PCT) design was used.BPH patients received drug therapy including α-adrenergic receptor blocker,5α reductase inhibitor,and combination therapy were followed up for 4 years.Multilevel statistical model was used to compare the scores of international prostate symtom score(IPSS) and BPH qality of life scale(QLS) among the 3 therapeutic regimens.Results The intra class correlation coefficients of I-PSS and BPH-QLS were 0.6136 and 0.6946 respectively,which indicated that both data were hierarchical structured.During the follow-up period,scores of IPSS and BPH-QLS were improved along with the drug therapy in 3 regimens.There was curve relationship between treatment time and IPSS and BPH-QLS scores in 3 regimens (all P＜0.05),and there was no significant differences in the trend of curves between the 3 regimens (P＞0.05).Conclusions For BPH patients with moderate symptoms bothering the quality of life,α-adrenergic receptor blocker,5α-reductase inhibitor,or combination therapy are significantly effective in reducing symptoms and improving quality of life.There are no efficacy differences among the 3 drug therapy during the 4-years follow-up.Compared with traditional analysis,multilevel statistical model is a more suitable and precise method for assessment of BPH treatments.
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Content validity is the degree to which an instrument has an appropriate sample of items for the construct being measured and is an important procedure in scale development. Content validity index (CVI) is the most widely used index in quantitative evaluation. There are 2 kinds of CVI: I-CVI and S-CVI. A method to compute a modified kappa statistic (K*) can be used to adjust I-CVI for chance agreement. S-CVI/UA and S-CVI/Ave are both scale level CVI with different formulas. Researchers recommend that a scale with excellent content validity should be composed of I-CVIs of 0.78 or higher and S-CVI/UA and S-CVI/Ave of 0.8 and 0.9 or higher, respectively. The characteristics and qualifications of the experts, process and main results of content validity evaluation should be reported in scale-related manuscript.