Abstract
BackgroundChronic disease has become one of the leading causes of poverty in China, which posed heavy economic burden on individuals, households and society, and accounts for an estimated 80% of deaths and 70% of disability-adjusted life-years lost now in China. This study aims to assess the effect of chronic diseases on health payment-induced poverty in Shaanxi Province, China.MethodsThe data was from the 5th National Health Survey of Shaanxi Province, which was part of China’s National Health Service Survey (NHSS) conducted in 2013. Totally, 20,700 households were selected for analysis. We used poverty headcount, poverty gap and mean positive poverty gap to assess the incidence, depth and intensity of poverty before and after health payment, respectively. Logistic regression models were further undertaken to evaluate the influence of percentage of chronic patients in households on the health payment-induced poverty with the control of other covariates.ResultsIn rural areas, the incidence of poverty increased 31.90% before and after health payment in the household group when the percentage of chronic patients in the households was 0, and the poverty gap rose from 932.77 CNY to 1253.85 CNY (50.56% increased). In the group when the percentage of chronic patients in the households was 1–40% and 41–50%, the poverty gap increased 76.78 and 89.29%, respectively. In the group when the percentage of chronic patients in the households was 51~ 100%, the increase of poverty headcount and poverty gap was 49.89 and 46.24%. In the logistic model, we found that the proportion of chronic patients in the households was closely related with the health payment-induced poverty. The percentage of chronic disease in the households increased by 1 %, the incidence of poverty increased by 1.01 times. On the other hand, the male household head and the household’s head with higher educational lever were seen as protective factors for impoverishment.ConclusionsWith the percentage of chronic patients in the households growing, the health payment-induced poverty increases sharply. Furthermore, the households members with more chronic diseases in rural areas were more likely to suffer poverty than those in urban areas. Our analysis emphasizes the need to protect households from the impoverishment of chronic diseases, and our findings will provide suggestions for further healthcare reforms in China and guidance for vulnerable groups.
Highlights
Chronic disease has become one of the leading causes of poverty in China, which posed heavy economic burden on individuals, households and society, and accounts for an estimated 80% of deaths and 70% of disability-adjusted life-years lost in China
Members with chronic diseases had a higher chance of experiencing health payment-induced poverty than those without, which is consistent in both developed countries and developing countries
According to a study conducted by Chunhong Jiang [9] showed that due to health expenses, an additional 10.53% of the families with a chronic patient got into poverty, which was more than twice the increase in the proportion of the families without a chronic patient
Summary
Chronic disease has become one of the leading causes of poverty in China, which posed heavy economic burden on individuals, households and society, and accounts for an estimated 80% of deaths and 70% of disability-adjusted life-years lost in China. This study aims to assess the effect of chronic diseases on health payment-induced poverty in Shaanxi Province, China. Chronic disease, defined as the diseases that affect people in a longer period in the future [2], mainly including cardiovascular diseases, diabetes, some cancers and so on [3], accounting for a majority of deaths and are responsible for a notable financial burden in low and middle-income countries, especially China [4, 5]. Chronic diseases impose heavy economic burdens on individuals, families and society. According to a study conducted by Chunhong Jiang [9] showed that due to health expenses, an additional 10.53% of the families with a chronic patient got into poverty, which was more than twice the increase in the proportion of the families without a chronic patient
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