{"title":"中国寒区原发性高血压和2型糖尿病家庭灾难性医疗支出的测量","authors":"Haofei Li, Xiangjin Cui, Yiyin Cao, Xu Jin, Jiaxuan Shi, Lei Leng, Lijun Xu, Tiemin Zhai, Weidong Huang","doi":"10.1186/s13561-025-00678-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study examines the incidence, intensity, and inequality of catastrophic health expenditure (CHE) among households with hypertension and type 2 diabetes mellitus (T2DM) in cold regions of China. It also explores key drivers of CHE and compares across diseases.</p><p><strong>Methods: </strong>Using data from the 2023 Seventh Health Services Survey in Heilongjiang Province, this study applies the World Health Organization's (WHO) normative algorithm for basic food needs to analyze CHE incidence, average gap (G<sub>cat</sub>), and mean positive gap (MPG) in 1,051 hypertension households and 294 T2DM households. The concentration curve and concentration index (CI) are used to quantify CHE inequality. Key drivers of CHE are analyzed through univariate analysis, Logistic regression, and Tobit regression models.</p><p><strong>Results: </strong>The CHE incidence for hypertension and T2DM households were 31.11% and 34.69%, respectively. The G<sub>cat</sub> was 6.38% for hypertension households and 7.02% for T2DM households, while the MPG was 20.51% and 20.24%, respectively. The CI for hypertension and T2DM households were - 0.2541 and - 0.2762. CHE decreased as economic status improved but increased with the number of chronic conditions. Under different CHE thresholds, the incidence and G<sub>cat</sub> of CHE in T2DM households are generally higher than in hypertension households, but the MPG in hypertension households is slightly higher than in T2DM households. Determinant analysis revealed that low household economic status, multiple chronic conditions, and utilization of outpatient and inpatient services are significant drivers of CHE in chronic disease households, while being employed and having a larger household size are important protective factors.</p><p><strong>Conclusion: </strong>Households with hypertension and T2DM in cold regions of China face a high risk of CHE, particularly among those with lower economic status. There is a pressing need for a more equitable healthcare financing system and improved management of chronic diseases in these populations.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"81"},"PeriodicalIF":3.3000,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522244/pdf/","citationCount":"0","resultStr":"{\"title\":\"Measurement of catastrophic health expenditures in households with essential hypertension and type 2 diabetes mellitus in cold regions of China.\",\"authors\":\"Haofei Li, Xiangjin Cui, Yiyin Cao, Xu Jin, Jiaxuan Shi, Lei Leng, Lijun Xu, Tiemin Zhai, Weidong Huang\",\"doi\":\"10.1186/s13561-025-00678-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study examines the incidence, intensity, and inequality of catastrophic health expenditure (CHE) among households with hypertension and type 2 diabetes mellitus (T2DM) in cold regions of China. It also explores key drivers of CHE and compares across diseases.</p><p><strong>Methods: </strong>Using data from the 2023 Seventh Health Services Survey in Heilongjiang Province, this study applies the World Health Organization's (WHO) normative algorithm for basic food needs to analyze CHE incidence, average gap (G<sub>cat</sub>), and mean positive gap (MPG) in 1,051 hypertension households and 294 T2DM households. The concentration curve and concentration index (CI) are used to quantify CHE inequality. Key drivers of CHE are analyzed through univariate analysis, Logistic regression, and Tobit regression models.</p><p><strong>Results: </strong>The CHE incidence for hypertension and T2DM households were 31.11% and 34.69%, respectively. The G<sub>cat</sub> was 6.38% for hypertension households and 7.02% for T2DM households, while the MPG was 20.51% and 20.24%, respectively. The CI for hypertension and T2DM households were - 0.2541 and - 0.2762. CHE decreased as economic status improved but increased with the number of chronic conditions. Under different CHE thresholds, the incidence and G<sub>cat</sub> of CHE in T2DM households are generally higher than in hypertension households, but the MPG in hypertension households is slightly higher than in T2DM households. Determinant analysis revealed that low household economic status, multiple chronic conditions, and utilization of outpatient and inpatient services are significant drivers of CHE in chronic disease households, while being employed and having a larger household size are important protective factors.</p><p><strong>Conclusion: </strong>Households with hypertension and T2DM in cold regions of China face a high risk of CHE, particularly among those with lower economic status. There is a pressing need for a more equitable healthcare financing system and improved management of chronic diseases in these populations.</p>\",\"PeriodicalId\":46936,\"journal\":{\"name\":\"Health Economics Review\",\"volume\":\"15 1\",\"pages\":\"81\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522244/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Economics Review\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://doi.org/10.1186/s13561-025-00678-9\",\"RegionNum\":3,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Economics Review","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1186/s13561-025-00678-9","RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
Measurement of catastrophic health expenditures in households with essential hypertension and type 2 diabetes mellitus in cold regions of China.
Objective: This study examines the incidence, intensity, and inequality of catastrophic health expenditure (CHE) among households with hypertension and type 2 diabetes mellitus (T2DM) in cold regions of China. It also explores key drivers of CHE and compares across diseases.
Methods: Using data from the 2023 Seventh Health Services Survey in Heilongjiang Province, this study applies the World Health Organization's (WHO) normative algorithm for basic food needs to analyze CHE incidence, average gap (Gcat), and mean positive gap (MPG) in 1,051 hypertension households and 294 T2DM households. The concentration curve and concentration index (CI) are used to quantify CHE inequality. Key drivers of CHE are analyzed through univariate analysis, Logistic regression, and Tobit regression models.
Results: The CHE incidence for hypertension and T2DM households were 31.11% and 34.69%, respectively. The Gcat was 6.38% for hypertension households and 7.02% for T2DM households, while the MPG was 20.51% and 20.24%, respectively. The CI for hypertension and T2DM households were - 0.2541 and - 0.2762. CHE decreased as economic status improved but increased with the number of chronic conditions. Under different CHE thresholds, the incidence and Gcat of CHE in T2DM households are generally higher than in hypertension households, but the MPG in hypertension households is slightly higher than in T2DM households. Determinant analysis revealed that low household economic status, multiple chronic conditions, and utilization of outpatient and inpatient services are significant drivers of CHE in chronic disease households, while being employed and having a larger household size are important protective factors.
Conclusion: Households with hypertension and T2DM in cold regions of China face a high risk of CHE, particularly among those with lower economic status. There is a pressing need for a more equitable healthcare financing system and improved management of chronic diseases in these populations.
期刊介绍：
Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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