NDLI: Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study

Content Provider	Springer Nature : BioMed Central
Author	Li, Zhong Hung, Peiyin He, Ruibo Tu, Xiaoming Li, Xiaoming Xu, Chengzhong Lu, Fangfang Zhang, Pei Zhang, Liang
Abstract	Background Disparities in the utilization, expenditures, and quality of care by insurance types have been well documented. Such comparisons have yet to be investigated in end-of-life (EOL) settings in China, where public insurance covers over 95% of the Chinese population. This study examined the associations between health insurance and EOL care in the last six months of life: outpatient visits, emergency department (ED) visits, inpatient services, intensive care unit (ICU) admissions, expenditures, and place of death among the cancer patients. Methods A total of 398 patients diagnosed with cancer who survived more than 6 months after diagnosis and died from July 2015 to June 2017 in urban Yichang, China, were included. Descriptive analysis and multivariate regression models were used to investigate the bivariate and independent associations, respectively, between health insurance with EOL healthcare utilization, expenditures and place of death. Results Urban Employee Basic Medical Insurance (UEBMI) beneficiaries visited EDs more frequently than Urban Resident-based Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS) beneficiaries (marginal effects [95% Confidence Interval]: 2.15 [1.81–2.48] and 1.92 [1.59–2.26], respectively). NRCMS and UEBMI beneficiaries had more hospitalizations than URBMI beneficiaries (1.01 [0.38–1.64] and 0.71 [0.20–1.22], respectively). Compared to URBMI beneficiaries, NRCMS beneficiaries and UEBMI beneficiaries had ¥15,722 and ¥43,241 higher expenditures. Similarly, UEBMI beneficiaries were most likely to die in hospitals, followed by NRCMS (UEBMI vs. NRCMS: 0.23 [0.11–0.36]) and URBMI (UEBMI vs. URBMI: 0.67 [0.57–0.78]) beneficiaries. Conclusions The disproportionately lower utilization of EOL care among NRCMS and URBMI beneficiaries, compared to UEBMI beneficiaries, raised concerns regarding quality of EOL care and financial burdens of NRCMS and URBMI beneficiaries. Purposive hospice care intervention might be warranted to address EOL care for these beneficiaries in China.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-020-09463-1.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-020-09463-1
Journal	BMC Public Health
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-09-04
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health End-of-life care Expenditures Place of death Health insurance Cancer patients Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Age-based disparities in end-of-life decisions in Belgium: a population-based death certificate survey

Retrospective analysis of population-based causes of death and life expectancy in urban Western China from 2003 to 2012

Understanding the rapid increase in life expectancy in shanghai, China: a population-based retrospective analysis

Advance directives and end-of-life care preferences among adults in Wuhan, China: a cross-sectional study

Community readiness to address disparities in access to cancer, palliative and end-of-life care for ethnic minorities

Association of rurality, type of primary caregiver and place of death with end-of-life medical expenditures among the oldest-old population in China

Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis

Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada

Disparities in appendicitis rupture rate among mentally ill patients

Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study

Similar Documents

Age-based disparities in end-of-life decisions in Belgium: a population-based death certificate survey

Retrospective analysis of population-based causes of death and life expectancy in urban Western China from 2003 to 2012

Understanding the rapid increase in life expectancy in shanghai, China: a population-based retrospective analysis

Advance directives and end-of-life care preferences among adults in Wuhan, China: a cross-sectional study

Community readiness to address disparities in access to cancer, palliative and end-of-life care for ethnic minorities

Association of rurality, type of primary caregiver and place of death with end-of-life medical expenditures among the oldest-old population in China

Assessment of changes in place of death of older adults who died from dementia in the United States, 2000–2014: a time-series cross-sectional analysis

Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada

Disparities in appendicitis rupture rate among mentally ill patients

Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study