Abstract
Background Traditional Chinese medicine (TCM) has long been widely adopted by the Chinese people and has been covered by China's basic medical insurance schemes to treat ischemic stroke. Previous research has mainly highlighted the therapy effect of TCM on ischemic stroke patients. Some studies have demonstrated that employing TCM can reduce the medical burden on other diseases. But no research has explored whether using TCM could reduce inpatient medical cost for ischemic stroke in mainland China. The purpose of this study is to investigate the impact of the use of TCM on the total inpatient cost of ischemic stroke and to explore whether TCM has played the role of being complementary to, or an alternative for, conventional medicine to treat ischemic stroke. Methods We conducted a national cross-sectional analysis based on a 5% random sample from claims data of China Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) schemes in 2015. Mann–Whitney test was used to compare unadjusted total inpatient cost, conventional medication cost, and nonpharmacy cost estimates. Ordinary least square regression analysis was performed to compare demographics-adjusted total inpatient cost and to examine the association between TCM cost and conventional medication cost. Results A total of 47321 urban inpatients diagnosed with ischemic stroke were identified in our study, with 92.6% (43843) of the patients using TCM in their inpatient treatment. Total inpatient cost for TCM users was significantly higher than TCM nonusers (USD 1217 versus USD 1036, P < 0.001). Conventional medication cost was significantly lower for TCM users (USD 335 versus USD 436, P < 0.001). The average cost of TCM per patient among TCM users was USD 289. Among TCM users, conventional medication costs were found to be positively associated with TCM cost after adjusting for confounding factors (Coef. = 0.144, P < 0.001). Conclusion Although the use of TCM reduced the cost of conventional medicine compared with TCM nonusers, TCM imposed an extra financial component on the total inpatient cost on TCM users. Our study suggests that TCM mainly played a complementary role to conventional medicine in ischemic stroke treatment in mainland China.
Highlights
Traditional Chinese medicine (TCM) has long been widely adopted by the Chinese people and has been covered by China’s basic medical insurance schemes to treat ischemic stroke
Stroke claimed over 6 million lives in 2017, becoming the third leading cause of both death and disability-adjusted life-years (DALYs) [1, 2]. e health care expenditure spent on stroke imposed a significant economic burden on health systems, estimated at over €27 billion in Europe alone in 2020 [3], and imposed a heavy financial burden on families with stroke victims, especially in lowand middle-income countries [1]
E median age of our sample was 68 years; 63.3% (29950) of patients participated in the Urban Employee Basic Medical Insurance (UEBMI) scheme; 14.8% of patients received medical treatment in TCM hospitals, but significantly more TCM users were treated in TCM hospitals (15.1%) than TCM nonusers (11.2%) (P < 0.001)
Summary
Traditional Chinese medicine (TCM) has long been widely adopted by the Chinese people and has been covered by China’s basic medical insurance schemes to treat ischemic stroke. No research has explored whether using TCM could reduce inpatient medical cost for ischemic stroke in mainland China. E purpose of this study is to investigate the impact of the use of TCM on the total inpatient cost of ischemic stroke and to explore whether TCM has played the role of being complementary to, or an alternative for, conventional medicine to treat ischemic stroke. Ordinary least square regression analysis was performed to compare demographics-adjusted total inpatient cost and to examine the association between TCM cost and conventional medication cost. The use of TCM reduced the cost of conventional medicine compared with TCM nonusers, TCM imposed an extra financial component on the total inpatient cost on TCM users. Our study suggests that TCM mainly played a complementary role to conventional medicine in ischemic stroke treatment in mainland China. While Chinese stroke patients mainly receive conventional modern medicine in their treatment, it has been claimed that conventional medicine fails to some degree to optimally treat or reduce costs of stroke [7,8,9]
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