Reports on Stroke from University of Oxford Provide New Insights (Association Between Health Insurance Cost-sharing and Choice of Hospital Tier for Cardiovascular Diseases In China: a Prospective Cohort Study): Cerebrovascular Diseases and Conditions – Stroke

2024 MAY 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Cerebrovascular Diseases and Conditions - Stroke. According to news reporting originating in Oxford, United Kingdom, by NewsRx journalists, research stated, “Hospitals in China are classified into tiers (1, 2 or 3), with the largest (tier 3) having more equipment and specialist staff. Differential health insurance cost-sharing by hospital tier (lower deductibles and higher reimbursement rates in lower tiers) was introduced to reduce overcrowding in higher tier hospitals, promote use of lower tier hospitals, and limit escalating healthcare costs.”

Financial supporters for this research include Wellcome Trust, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, National Natural Science Foundation of China National Outstanding Youth Science Fund Project, Medical Research Council, Kadoorie Charitable Foundation, National Natural Science Foundation of China, National Key Research and Development Program of China, National Key Research and Development Program of China Stem Cell and Translational Research, British Heart Foundation, Cancer Research UK.

The news reporters obtained a quote from the research from the University of Oxford, “However, little is known about the effects of differential cost-sharing in health insurance schemes on choice of hospital tiers. In a 9-year follow-up of a prospective study of 0.5 M adults from 10 areas in China, we examined the associations between differential health insurance cost-sharing and choice of hospital tiers for patients with a first hospitalisation for stroke or ischaemic heart disease (IHD) in 2009-2017. Analyses were performed separately in urban areas (stroke: n = 20,302; IHD: n = 19,283) and rural areas (stroke: n = 21,130; IHD: n = 17,890), using conditional logit models and adjusting for individual socioeconomic and health characteristics. About 64-68% of stroke and IHD cases in urban areas and 27-29% in rural areas chose tier 3 hospitals. In urban areas, higher reimbursement rates in each tier and lower tier 3 deductibles were associated with a greater likelihood of choosing their respective hospital tiers. In rural areas, the effects of cost-sharing were modest, suggesting a greater contribution of other factors. Higher socioeconomic status and greater disease severity were associated with a greater likelihood of seeking care in higher tier hospitals in urban and rural areas. Patient choice of hospital tiers for treatment of stroke and IHD in China was influenced by differential cost-sharing in urban areas, but not in rural areas.”

According to the news reporters, the research concluded: “Further strategies are required to incentivise appropriate health seeking behaviour and promote more efficient hospital use.”

For more information on this research see: Association Between Health Insurance Cost-sharing and Choice of Hospital Tier for Cardiovascular Diseases In China: a Prospective Cohort Study. The Lancet Regional Health - Western Pacific, 2024;45:101020. The Lancet Regional Health - Western Pacific can be contacted at: Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands.

Our news correspondents report that additional information may be obtained by contacting Muriel Levy, University of Oxford, Nuffield Dept. of Population Health, Clin Trial Serv Unit & Epidemiol Studies Unit Ctsu, Oxford, United Kingdom. Additional authors for this research include Robert Clarke, Daniel Avery, Zhengming Chen, Yiping Chen, John Buckell, Borislava Mihaylova, Nina Wu, Pei Pei, Dianjianyi Sun, Jun Lv, Canqing Yu, Liming Li, Hua Zhang and Winnie Yip.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.lanwpc.2024.101020. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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