Out-of-pocket and reimbursed expenses of inpatients with major non-communicable chronic diseases in China, 2013

  Objective  To estimate self-paid and reimbursed medical expenses among major non-communicable chronic diseases (NCDs) during 2013 for developing strategies on alleviating disease-related economic burden in China.

  Methods  The data on 6 978 inpatients with cancer, diabetes, cardiovascular or cerebrovascular disease, and chronic respiratory disease were extracted from the Fifth National Health Services Survey conducted in 2013. We also collected the data related to total hospital discharges of the inpatients with the four major NCDs in 2013 from the China Population Statistics Yearbook – 2014 and the China Health and Family Planning Statistics Yearbook – 2014. Then, the self-paid and reimbursed medical expenses of the 6 978 inpatients were analyzed and those for all the hospitalization due to the major NCDs were estimated.

  Results  For the inpatients with the four major NCDs, those with cancer had both the highest calculated self-paid hospitalization medical expense per capita (4 553 and 5 000 yuan RMB for the inpatients from urban and rural regions) and the highest estimated total self-paid medical expense for all hospital discharges in the year (46.509 billion yuan); the inpatients with cancer also had the highest calculated medical expense per capita (7 800 and 4 800 yuan for the inpatients from urban and rural regions) reimbursed by medical insurance reimbursement, but the inpatients with cardiovascular or cerebrovascular diseases had the highest estimated total reimbursed medical expense for all hospital discharges in the year (88.787 billion yuan). The inpatients with cancer had the highest calculated total hospitalization medical expense per capita (13 000 and 10 000 yuan for the inpatients from urban and rural regions) but the inpatients with cardiovascular or cerebrovascular diseases had the highest estimated total medical expense for all hospital discharges in the year (148.569 billion yuan). The inpatients with Urban Resident Basic Medical Insurance (MIUR) had the lowest ratio (54.06%) of hospitalization expense reimbursement compared to the inpatients with other types of basic medical insurance.

  Conclusion  Among the inpatients with major non-communicable chronic diseases, the self-paid and reimbursed hospitalization medical expense per capita are the highest for the inpatients with cancer but the total medical expense is the highest for the inpatients with cardiovascular or cerebrovascular diseases. The ratio of hospitalization expense reimbursement by MIUR is relatively lower than that by other types of basic medical insurance.