PMID- 20727137
OWN - NLM
STAT- MEDLINE
DCOM- 20101108
LR  - 20220409
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 10
DP  - 2010 Aug 20
TI  - Factors affecting costs and utilization of type 2 diabetes healthcare: a 
      cross-sectional survey among 15 hospitals in urban China.
PG  - 244
LID - 10.1186/1472-6963-10-244 [doi]
AB  - BACKGROUND: Type 2 Diabetes mellitus (T2DM) affects persons of all ages, while 
      also placing heavy economic burdens on national economies and healthcare systems. 
      The study aims to investigate the determinants of direct medical cost (DMC), 
      out-of-pocket (OOP) proportion of the cost, and healthcare utilization associated 
      with T2DM. METHODS: This cross-sectional study was conducted in four major cities 
      in China. Eligible subjects were adult outpatients who received treatment at one 
      of 15 sampled secondary or tertiary hospitals and consecutively enrolled between 
      March 2007 and May 2007. Generalized estimating equations were used to determine 
      impact factors associated with DMC and healthcare utilization. RESULTS: Insurance 
      schemes and receiving insulin therapy were significantly associated with a higher 
      annual DMC of T2DM. For each increase in number of complications, there was about 
      33% increase in annual DMC. Insurance schemes were significantly associated with 
      the proportions of DMC from pocket. A 7% significantly lower proportion of DMC 
      was paid and 23% more clinic visits (AOR = 1.232, P < 0.001) were made by 
      patients admitted at secondary hospitals than tertiary hospitals. The group with 
      higher income (> 2000 CNY/month) paid 23% less from their pocket, compared with 
      the lower income group. The number of complications also significantly increased 
      the outpatient visits (AOR = 1.064, P < 0.001). CONCLUSIONS: It implies that 
      preventing complications through the use of more effective treatment regimens is 
      important in order to control the healthcare expenditures of the diseases. 
      Healthcare reform needs to be focused on the medical insurance system and 
      redistribution of patients in hospitals of different levels.
FAU - Wang, Weibing
AU  - Wang W
AD  - School of Public Health, Fudan University, China.
FAU - Fu, Chaowei
AU  - Fu C
FAU - Zhuo, Haijing
AU  - Zhuo H
FAU - Luo, Jianfeng
AU  - Luo J
FAU - Xu, Biao
AU  - Xu B
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100820
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - China
MH  - Cost of Illness
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/drug therapy/*economics
MH  - Female
MH  - Hospitals, Urban/*economics/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Multivariate Analysis
PMC - PMC2936377
EDAT- 2010/08/24 06:00
MHDA- 2010/11/09 06:00
PMCR- 2010/08/20
CRDT- 2010/08/24 06:00
PHST- 2009/10/16 00:00 [received]
PHST- 2010/08/20 00:00 [accepted]
PHST- 2010/08/24 06:00 [entrez]
PHST- 2010/08/24 06:00 [pubmed]
PHST- 2010/11/09 06:00 [medline]
PHST- 2010/08/20 00:00 [pmc-release]
AID - 1472-6963-10-244 [pii]
AID - 10.1186/1472-6963-10-244 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2010 Aug 20;10:244. doi: 10.1186/1472-6963-10-244.