Skip to main content
Top
Published in: BMC Health Services Research 1/2020

Open Access 01-12-2020 | Research article

Cluster analysis of differences in medical economic burden among residents of different economic levels in Guangdong Province, China

Authors: Jialong Chen, Liuna Yang, Zhenzhu Qian, Mingwei Sun, Honglin Yu, Xiaolei Ma, Chonghua Wan, Yunbin Yang

Published in: BMC Health Services Research | Issue 1/2020

Login to get access

Abstract

Background

This study compares and analyzes the differences of residents’ medical economic burden in different economic levels, explores the factors for improving the equity of health services in Guangdong, China.

Methods

Cluster analysis was carried out in 20 cities of Guangdong Province by taking 7 key factors on the equity of health services as indicators. Seven key factors were collected from Guangdong Statistical Yearbook 2017 and the Sixth National Population Census. R-type clustering was used to reduce the dimensionality of 7 candidate variables through similarity index. Q-type clustering was used to classify 20 cities in Guangdong Province.

Results

The cluster analysis divided Guangdong Province into three regions with different medical economic burden. The greater the proportion of the elderly over 65 years old, the greater the proportion of health care expenditure to per capita consumer expenditure of residents, and the heavier the medical economic burden. On average, 10.75% of the general budget expenditure of each city in Guangdong Province is spent on health care.

Conclusions

The lower per capita GDP, the higher proportion of the elderly over 65 years old and the lack of medical technicians are risk factors for the heavier medical burden of the residents and the fairness of health services. While increasing the health expenditure, the government needs to further complete the reform of the medical and health system, improve the efficiency of the medical system and curb the rapid rise of absolute health expenditures of individuals, which can reduce the economic burden of residents’ medical care.
Literature
1.
go back to reference Bauchner H, Fontanarosa PB. Health care spending in the United States compared with 10 other high-income countries: what Uwe Reinhardt might have said. JAMA. 2018;319(10):990–2.CrossRef Bauchner H, Fontanarosa PB. Health care spending in the United States compared with 10 other high-income countries: what Uwe Reinhardt might have said. JAMA. 2018;319(10):990–2.CrossRef
2.
go back to reference Parente ST. Factors contributing to higher health care spending in the United States compared with other high-income countries. JAMA. 2018;319(10):988–90.CrossRef Parente ST. Factors contributing to higher health care spending in the United States compared with other high-income countries. JAMA. 2018;319(10):988–90.CrossRef
3.
go back to reference Global Burden of Disease Health Financing Collaborator Network. Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet. 2019;393(10187):2233–60..CrossRef Global Burden of Disease Health Financing Collaborator Network. Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet. 2019;393(10187):2233–60..CrossRef
4.
go back to reference Luengo-Fernandez R, Leal J, Gray A, Sullivan R. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet Oncol. 2013;14(12):1165–74.CrossRef Luengo-Fernandez R, Leal J, Gray A, Sullivan R. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet Oncol. 2013;14(12):1165–74.CrossRef
5.
go back to reference Dou G, Wang Q, Ying X. Reducing the medical economic burden of health insurance in China: achievements and challenges. Biosci Trends. 2018;12(3):215–9.CrossRef Dou G, Wang Q, Ying X. Reducing the medical economic burden of health insurance in China: achievements and challenges. Biosci Trends. 2018;12(3):215–9.CrossRef
6.
go back to reference Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China's huge and complex health-care reforms. Lancet. 2012;379(9818):833–42.CrossRef Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China's huge and complex health-care reforms. Lancet. 2012;379(9818):833–42.CrossRef
7.
go back to reference Zeng JQ. The pilot results of 47 148 cases of BJ-DRGs-based payment in China. Int J Health Plann Manag. 2019;34(4):1386–98.CrossRef Zeng JQ. The pilot results of 47 148 cases of BJ-DRGs-based payment in China. Int J Health Plann Manag. 2019;34(4):1386–98.CrossRef
8.
go back to reference Meng Z, Zhu M, Cai Y, Cao X, Wu H. Effect of a typical systemic hospital reform on inpatient expenditure for rural population: the Sanming model in China. BMC Health Serv Res. 2019;19(1):231.CrossRef Meng Z, Zhu M, Cai Y, Cao X, Wu H. Effect of a typical systemic hospital reform on inpatient expenditure for rural population: the Sanming model in China. BMC Health Serv Res. 2019;19(1):231.CrossRef
9.
go back to reference Li L, Fu H. China’s health care system reform: Progress and prospects. Int J Health Plann Manag. 2017;32(3):240–53.CrossRef Li L, Fu H. China’s health care system reform: Progress and prospects. Int J Health Plann Manag. 2017;32(3):240–53.CrossRef
10.
go back to reference Deng J, Tian H, Guo Y, Ma T, Sun Y, Zhang S, Yang T, Tian X. A retrospective and prospective assessment of the zero-markup drug reform in China from the perspective of policy diffusion. Int J Health Plann Manag. 2018;33(4):e918–29.CrossRef Deng J, Tian H, Guo Y, Ma T, Sun Y, Zhang S, Yang T, Tian X. A retrospective and prospective assessment of the zero-markup drug reform in China from the perspective of policy diffusion. Int J Health Plann Manag. 2018;33(4):e918–29.CrossRef
11.
go back to reference Wagstaff A, Flores G, Hsu J, Smitz MF, Chepynoga K, Buisman LR, van Wilgenburg K, Eozenou P. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health. 2018;6(2):e169–79.CrossRef Wagstaff A, Flores G, Hsu J, Smitz MF, Chepynoga K, Buisman LR, van Wilgenburg K, Eozenou P. Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health. 2018;6(2):e169–79.CrossRef
12.
go back to reference Sisko AM, Keehan SP, Poisal JA, Cuckler GA, Smith SD, Madison AJ, Rennie KE, Hardesty JC. National health expenditure projections, 2018-27: economic and demographic Trends drive spending and enrollment growth. Health Aff (Millwood). 2019;38(3):491–501.CrossRef Sisko AM, Keehan SP, Poisal JA, Cuckler GA, Smith SD, Madison AJ, Rennie KE, Hardesty JC. National health expenditure projections, 2018-27: economic and demographic Trends drive spending and enrollment growth. Health Aff (Millwood). 2019;38(3):491–501.CrossRef
13.
go back to reference Chowdhury S, Gupta I, Trivedi M, Prinja S. Inequity & burden of out-of-pocket health spending: district level evidences from India. Indian J Med Res. 2018;148(2):180–9.CrossRef Chowdhury S, Gupta I, Trivedi M, Prinja S. Inequity & burden of out-of-pocket health spending: district level evidences from India. Indian J Med Res. 2018;148(2):180–9.CrossRef
14.
go back to reference Global Burden of Disease Health Financing Collaborator Network. Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet. 2017;389(10083):1981–2004.CrossRef Global Burden of Disease Health Financing Collaborator Network. Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet. 2017;389(10083):1981–2004.CrossRef
15.
go back to reference Xiong M, Li M, Zheng D, Wang X, Su T, Chen Y, Yang B. Evaluation of the economic burden of leprosy among migrant and resident patients in Guangdong Province, China. BMC Infect Dis. 2017;17(1):760.CrossRef Xiong M, Li M, Zheng D, Wang X, Su T, Chen Y, Yang B. Evaluation of the economic burden of leprosy among migrant and resident patients in Guangdong Province, China. BMC Infect Dis. 2017;17(1):760.CrossRef
16.
go back to reference Putri W, Muscatello DJ, Stockwell MS, Newall AT. Economic burden of seasonal influenza in the United States. Vaccine. 2018;36(27):3960–6.CrossRef Putri W, Muscatello DJ, Stockwell MS, Newall AT. Economic burden of seasonal influenza in the United States. Vaccine. 2018;36(27):3960–6.CrossRef
17.
go back to reference Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, Pratt M. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388(10051):1311–24.CrossRef Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, Pratt M. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388(10051):1311–24.CrossRef
18.
go back to reference Liqing L, Fuyi D, Lu Z, Qiaoyan L. Analysis of the influence and mechanism of residents’ income change on health expenditure in China. Health Economy in China. 2016;35(04):54–6. Liqing L, Fuyi D, Lu Z, Qiaoyan L. Analysis of the influence and mechanism of residents’ income change on health expenditure in China. Health Economy in China. 2016;35(04):54–6.
19.
go back to reference Xiuzhe M. A comparison of consumption income between urban and rural areas in Shandong Province. Contemp Econ. 2017;11:80–1. Xiuzhe M. A comparison of consumption income between urban and rural areas in Shandong Province. Contemp Econ. 2017;11:80–1.
20.
go back to reference Pan J, Tian S, Zhou Q, Han W. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance. Health Policy Plan. 2016;31(7):853–9.CrossRef Pan J, Tian S, Zhou Q, Han W. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance. Health Policy Plan. 2016;31(7):853–9.CrossRef
21.
go back to reference De Pietro C, Camenzind P, Sturny I, Crivelli L, Edwards-Garavoglia S, Spranger A, Wittenbecher F, Quentin W. Switzerland: health system review. Health Syst Transit. 2015;17(4):1–288.PubMed De Pietro C, Camenzind P, Sturny I, Crivelli L, Edwards-Garavoglia S, Spranger A, Wittenbecher F, Quentin W. Switzerland: health system review. Health Syst Transit. 2015;17(4):1–288.PubMed
22.
go back to reference Chevreul K, Berg BK, Durand-Zaleski I, Hernandez-Quevedo C. France: health system review. Health Syst Transit. 2015;17(3):1–218.PubMed Chevreul K, Berg BK, Durand-Zaleski I, Hernandez-Quevedo C. France: health system review. Health Syst Transit. 2015;17(3):1–218.PubMed
23.
go back to reference Lopreite M, Mauro M. The effects of population ageing on health care expenditure: a Bayesian VAR analysis using data from Italy. Health Policy. 2017;121(6):663–74.CrossRef Lopreite M, Mauro M. The effects of population ageing on health care expenditure: a Bayesian VAR analysis using data from Italy. Health Policy. 2017;121(6):663–74.CrossRef
24.
go back to reference Harris A, Sharma A. Estimating the future health and aged care expenditure in Australia with changes in morbidity. PLoS One. 2018;13(8):e201697.CrossRef Harris A, Sharma A. Estimating the future health and aged care expenditure in Australia with changes in morbidity. PLoS One. 2018;13(8):e201697.CrossRef
25.
go back to reference Duan W, Zheng A, Mu X, Li M, Liu C, Huang W, Wang X. How great is the medical burden of disease on the aged? Research based on “system of health account 2011”. Health Qual Life Outcomes. 2017;15(1):134.CrossRef Duan W, Zheng A, Mu X, Li M, Liu C, Huang W, Wang X. How great is the medical burden of disease on the aged? Research based on “system of health account 2011”. Health Qual Life Outcomes. 2017;15(1):134.CrossRef
26.
go back to reference Picco L, Achilla E, Abdin E, Chong SA, Vaingankar JA, McCrone P, Chua HC, Heng D, Magadi H, Ng LL, et al. Economic burden of multimorbidity among older adults: impact on healthcare and societal costs. BMC Health Serv Res. 2016;16:173.CrossRef Picco L, Achilla E, Abdin E, Chong SA, Vaingankar JA, McCrone P, Chua HC, Heng D, Magadi H, Ng LL, et al. Economic burden of multimorbidity among older adults: impact on healthcare and societal costs. BMC Health Serv Res. 2016;16:173.CrossRef
27.
go back to reference Wang C, Li F, Wang L, Zhou W, Zhu B, Zhang X, Ding L, He Z, Song P, Jin C. The impact of population aging on medical expenses: a big data study based on the life table. Biosci Trends. 2018;11(6):619–31.CrossRef Wang C, Li F, Wang L, Zhou W, Zhu B, Zhang X, Ding L, He Z, Song P, Jin C. The impact of population aging on medical expenses: a big data study based on the life table. Biosci Trends. 2018;11(6):619–31.CrossRef
28.
go back to reference Shi J, Liu R, Jiang H, Wang C, Xiao Y, Liu N, Wang Z, Shi L. Moving towards a better path? A mixed-method examination of China's reforms to remedy medical corruption from pharmaceutical firms. BMJ Open. 2018;8(2):e18513.CrossRef Shi J, Liu R, Jiang H, Wang C, Xiao Y, Liu N, Wang Z, Shi L. Moving towards a better path? A mixed-method examination of China's reforms to remedy medical corruption from pharmaceutical firms. BMJ Open. 2018;8(2):e18513.CrossRef
29.
go back to reference Anand S, Fan VY, Zhang J, Zhang L, Ke Y, Dong Z, Chen LC. China’s human resources for health: quantity, quality, and distribution. Lancet. 2008;372(9651):1774–81.CrossRef Anand S, Fan VY, Zhang J, Zhang L, Ke Y, Dong Z, Chen LC. China’s human resources for health: quantity, quality, and distribution. Lancet. 2008;372(9651):1774–81.CrossRef
30.
go back to reference Lassi ZS, Musavi NB, Maliqi B, Mansoor N, de Francisco A, Toure K, Bhutta ZA. Systematic review on human resources for health interventions to improve maternal health outcomes: evidence from low- and middle-income countries. Hum Resour Health. 2016;14:10.CrossRef Lassi ZS, Musavi NB, Maliqi B, Mansoor N, de Francisco A, Toure K, Bhutta ZA. Systematic review on human resources for health interventions to improve maternal health outcomes: evidence from low- and middle-income countries. Hum Resour Health. 2016;14:10.CrossRef
Metadata
Title
Cluster analysis of differences in medical economic burden among residents of different economic levels in Guangdong Province, China
Authors
Jialong Chen
Liuna Yang
Zhenzhu Qian
Mingwei Sun
Honglin Yu
Xiaolei Ma
Chonghua Wan
Yunbin Yang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-020-05817-y

Other articles of this Issue 1/2020

BMC Health Services Research 1/2020 Go to the issue