Abstract
Objectives: This study aimed to measure the induction level of drug welfare in Chinese patients with chronic diseases using a bivariate Theil index.Design: The bivariate Theil-T index was used to hierarchically decompose the relevant survey data, and the contribution rate of the intragroup gap and the intergroup gap to the total gap was investigated to better understand the current drug welfare induction level of Chinese patients with chronic diseases.Setting: The study was based in Gansu, Sichuan, Hebei, and Zhejiang provinces in China.Participants: Survey data was from patients with chronic diseases in 20 hospitals in four provinces.Primary and secondary outcome measures: Data was collected through a questionnaire designed by the research team after expert consultation. Using the variables represented by the index system to decompose the Theil index from the two dimensions of the region and urban and rural areas. SPSS 22.0 was used for reliability and validity analysis and Theil index calculation.Results: The overall level of drug welfare induction in Chinese patients with chronic diseases had a high degree of equalization. The overall Theil index was 0.0003, but there were still some differences among groups.Conclusions: To improve the drug welfare equalization induction level of patients with chronic diseases in China, the government should start from western rural areas, and policy should target the provinces that were in a disadvantaged position within the region to promote the equalization of drug welfare induction level for patients with chronic diseases in China.
Highlights
With the change of the human disease spectrum, chronic diseases currently account for the majority of global morbidity, and mortality [1, 2]
The National Natural Science Foundation project hosted by the author, “Optimization of Health and Precision Poverty Alleviation Policy Based on the Improvement of the Drug Welfare Effect of Poverty Chronic Patients,” has made a detailed study on the construction of the evaluation index system for the drug welfare level of patients with chronic diseases in China [Min [22] “Study on the Evaluation and Promotion Strategy of the Drug Welfare Effect of Patients with Chronic Diseases in 10 Provinces Based on the Topsis Method;” Yini (2018) [23] “Study on the Drug Welfare Effect of Patients with Chronic Diseases Based on the Two-Step Clustering Method”]
The Regional Dimension Decomposition Results of the T-Values of Each Index After decomposing the T-value according to each indicator, the T-values of “I1: The number of medical service institutions that can be reached within 15 min,” “I6: The expensive needed drug is not affordable” and “I14: Second reimbursement level of drug expenses” are higher than the other indicators, the values are 0.0050, 0.0046, and 0.0054, respectively, and the T-values are all >0.0040, which means that the level of equalization of the drug welfare level of these three indicators is relatively low
Summary
With the change of the human disease spectrum, chronic diseases currently account for the majority of global morbidity, and mortality [1, 2]. It is expected that by 2020, chronic non-communicable diseases (chronic diseases) will become the leading cause of death and disability in humans [3, 4] and the most crucial disease burden in China. Known as non-communicable diseases (NCDS), are ongoing and often incurable diseases or conditions that require ongoing medical care and affect a person’s daily life [5, 6]. It reported that 80–92% of older adults have at least one chronic illness and 50–77% have two or more [7]. It has been reported that ∼63% of all deaths in the world are attributed to NCDs, and this causes great socioeconomic harm to all countries, developing countries [12]
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