A Study On Catastrophic Health Payment And Financial Risk Of Disease In Taiyuan

Objective:This study aims to make an objective evaluation on the disease economic risk through the investigation on the family health expenditure situation of the residents in Taiyuan,by adopting the method of catastrophic health payment and financial risk of disease,which are recommended by the World Health Organization;meanwhile,this study makes an analysis on the influence factors of the catastrophic health payment and provides some suggestions of health policy to the potential risk factors,helping residents enhance their ability of resisting the financial risk of disease.Methods:First,referring to The National Health Services Survey and the purpose of the survey,make an investigation on the basic situations of the sample families,families' economic situation,family members,and other relevant circumstances of the families by making the residents in Taiyuan as the research subjects,and there are 455 valid questionnaires in total.Then,investigate and analyze the conditions of the financial risk of disease by using the health economic index and the specific measurable indexes are: the incidence rate of the catastrophic health payment,average gap,relative gap,the general financial risk of disease and the relative financial risk of disease.Last,the logistic regression model is used to identify the influence factors that bring out the catastrophic health payment under the different defined standards.Results:1.Catastrophic health payment(1)In 15% threshold,the incidence rate of the catastrophic health payment is 37.58%,and the average gap is 7.28% while the relative gap is 19.36%;under the standard of 40%,the incidence rate is 13.41%,the average gap and the relative gap are 2.14% and 15.95% respectively,among which the incidence rate in overall decline is 24.17 percentage points.(2)In 15% threshold,the incidence rate of the catastrophic health payment in the poorest families is 42.86%,which is 5.25 percentage points(37.58%)higher than that of the overall incidence rate;in 30% and 40% thresholds,the incidence rate of the poorest families is 2~3 times that of the most wealthy families.(3)In 40% threshold,to the families that have chronic patients,with people more than 65 years of age,or have hospitalizations over the past year,the incidence rates are separately 5.37 times,3.83 times,and 1.86 times that of the families without these cases.(4)To the families who did not join in the medical insurance,the occurrence rate of the catastrophic health payment may reach 65.22%,and little change occurs under different standards;under the standard of 30%,to the families who join the NCMS,the incidence rate is 17.91%,which are 1.81 times and 2.21 times respectively that of the urban medical insurance of workers(9.87%)and the urban medical insurance of residents(8.13%).And the gap is larger.2.Financial risk of diseaseOverall,it mainly focuses on the economic risk of low-grade diseases,which occupies 98.68% of the family investigated,and there is no family investigated in the state of economic risk of high-grade diseases;to the families who have chronic patients,people more than 65 years of age,and hospitalizations in the past year,the rates of the relative risk are 2.53 times,2.15 times,1.79 times separately that of the families without these characteristics at that time;after making collections,the relative financial risk of disease in the poorest group,the relative poor group and the intermediate group are all above 1,and that of the relative wealthy group and the most wealthy group are all below 1,and the collection RR of the poorest group is 2.62 times that of the most wealthy group.3.The influence factors of the catastrophic health paymentThe influence factors of the catastrophic health payment include: the chronic patient,people more than 65 years of age,hospitalization in a family,the type of the medical insurance and the family income level.Conclusions:1.The incidence rate of the catastrophic health payment in the survey households decreases with the improvement of the defined criteria.In different definition standards and family characteristics,the Cat occurrence rate and gap are different.2.The financial risk of disease in the families surveyed is basically the financial risk of the low-grade diseases,and to the families who have chronic patients,people more than 65 years of age and hospitalization,the relative rate of the financial risk of disease is higher than that of the ordinary families.3.The Cat occurrence rate and gap in survey area is still relatively high,chronic patient,insurance type and family income level(P<0.05)are the main factors.