Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis
ObjectiveTo evaluate the incidence and trend of catastrophic health expenditures (CHE) in China over the past 20 years and explore the socioeconomic factors affecting China's CHE rate.MethodsThe systematic review was conducted according to the Cochrane Handbook and reported according to PRISMA....
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| Format: | Article |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.997694/full |
| _version_ | 1828072009159933952 |
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| author | Fangkai Zhang Fangkai Zhang Jianjun Jiang Jianjun Jiang Min Yang Min Yang Min Yang Kun Zou Kun Zou Kun Zou Kun Zou Dandi Chen Dandi Chen |
| author_facet | Fangkai Zhang Fangkai Zhang Jianjun Jiang Jianjun Jiang Min Yang Min Yang Min Yang Kun Zou Kun Zou Kun Zou Kun Zou Dandi Chen Dandi Chen |
| author_sort | Fangkai Zhang |
| collection | DOAJ |
| description | ObjectiveTo evaluate the incidence and trend of catastrophic health expenditures (CHE) in China over the past 20 years and explore the socioeconomic factors affecting China's CHE rate.MethodsThe systematic review was conducted according to the Cochrane Handbook and reported according to PRISMA. We searched English and Chinese literature databases, including PubMed, EMbase, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang, China Science and Technology Journal Database (CQVIP), and CBM (Sino Med), for empirical studies on the CHE rate in China and its associated socioeconomic factors from January 2000 to June 2020. Two reviewers conducted the study selection, data extraction, and quality appraisal. The secular trend of the CHE rate was examined, and factors associated with CHE were explored using subgroup analysis and meta-regression.ResultsA total of 118 eligible studies with 1,771,726 participants were included. From 2000 to 2020, the overall CHE rate was 25.2% (95% CI: 23.4%−26.9%) in China. The CHE rate continued to rise from 13.0% in 2000 to 32.2% in 2020 in the general population. The CHE rate was higher in urban areas than in rural areas, higher in the western than the northeast, eastern, and central region, in the elderly than non-elderly, in low-income groups than non-low-income groups, in people with cancer, chronic infectious disease, and cardio-cerebrovascular diseases (CCVD) than those with non-chronic disease group, and in people with NCMS than those with URBMI and UEBMI. Multiple meta-regression analyses found that low-income, cancer, CCVD, unspecified medical insurance type, definition 1 and definition 2 were correlated with the CHE rate, while other factors were all non-significantly correlated.ConclusionIn the past two decades, the CHE rate in China has been rising. The continuous rise of health expenditures may be an important reason for the increasing CHE rate. Age, income level, and health status affect the CHE rate. Therefore, it is necessary to find ways to meet the medical needs of residents and, at the same time, control the unreasonable rapid increase in health expenditures in China. |
| first_indexed | 2024-04-11T01:02:33Z |
| format | Article |
| id | doaj.art-ed17488305c043219f278fa887a68951 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-11T01:02:33Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj.art-ed17488305c043219f278fa887a689512023-01-04T15:04:47ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-01-011010.3389/fpubh.2022.997694997694Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysisFangkai Zhang0Fangkai Zhang1Jianjun Jiang2Jianjun Jiang3Min Yang4Min Yang5Min Yang6Kun Zou7Kun Zou8Kun Zou9Kun Zou10Dandi Chen11Dandi Chen12West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaResearch Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, ChinaWest China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaResearch Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, ChinaWest China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaWest China Research Centre for Rural Health Development, Sichuan University, Chengdu, Sichuan, ChinaFaculty of Health, Art and Design, Swinbune Technology University, Melbourne, VIC, AustraliaDepartment of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, ChinaEvidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, ChinaNMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, ChinaWest China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, ChinaResearch Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, ChinaObjectiveTo evaluate the incidence and trend of catastrophic health expenditures (CHE) in China over the past 20 years and explore the socioeconomic factors affecting China's CHE rate.MethodsThe systematic review was conducted according to the Cochrane Handbook and reported according to PRISMA. We searched English and Chinese literature databases, including PubMed, EMbase, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang, China Science and Technology Journal Database (CQVIP), and CBM (Sino Med), for empirical studies on the CHE rate in China and its associated socioeconomic factors from January 2000 to June 2020. Two reviewers conducted the study selection, data extraction, and quality appraisal. The secular trend of the CHE rate was examined, and factors associated with CHE were explored using subgroup analysis and meta-regression.ResultsA total of 118 eligible studies with 1,771,726 participants were included. From 2000 to 2020, the overall CHE rate was 25.2% (95% CI: 23.4%−26.9%) in China. The CHE rate continued to rise from 13.0% in 2000 to 32.2% in 2020 in the general population. The CHE rate was higher in urban areas than in rural areas, higher in the western than the northeast, eastern, and central region, in the elderly than non-elderly, in low-income groups than non-low-income groups, in people with cancer, chronic infectious disease, and cardio-cerebrovascular diseases (CCVD) than those with non-chronic disease group, and in people with NCMS than those with URBMI and UEBMI. Multiple meta-regression analyses found that low-income, cancer, CCVD, unspecified medical insurance type, definition 1 and definition 2 were correlated with the CHE rate, while other factors were all non-significantly correlated.ConclusionIn the past two decades, the CHE rate in China has been rising. The continuous rise of health expenditures may be an important reason for the increasing CHE rate. Age, income level, and health status affect the CHE rate. Therefore, it is necessary to find ways to meet the medical needs of residents and, at the same time, control the unreasonable rapid increase in health expenditures in China.https://www.frontiersin.org/articles/10.3389/fpubh.2022.997694/fullinfluencing factorssystematic reviewmeta-analysiscatastrophic health expendituresocial-economic risk factors |
| spellingShingle | Fangkai Zhang Fangkai Zhang Jianjun Jiang Jianjun Jiang Min Yang Min Yang Min Yang Kun Zou Kun Zou Kun Zou Kun Zou Dandi Chen Dandi Chen Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis Frontiers in Public Health influencing factors systematic review meta-analysis catastrophic health expenditure social-economic risk factors |
| title | Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis |
| title_full | Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis |
| title_fullStr | Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis |
| title_full_unstemmed | Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis |
| title_short | Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis |
| title_sort | catastrophic health expenditure incidence trend and socioeconomic risk factors in china a systematic review and meta analysis |
| topic | influencing factors systematic review meta-analysis catastrophic health expenditure social-economic risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.997694/full |
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