UNASSIGNED:评估过去20年中国灾难性卫生支出(CHE)的发生率和趋势,并探讨影响中国CHE率的社会经济因素。
UNASSIGNED:系统评价是根据Cochrane手册进行的,并根据PRISMA进行报告。我们检索了中英文文献数据库,包括PubMed,EMBase,WebofScience,中国国家知识基础设施(CNKI),万芳,中国科技期刊数据库(CQVIP),和煤层气(中医学),2000年1月至2020年6月,对中国CHE率及其相关社会经济因素进行了实证研究。两名评审人员进行了研究选择,数据提取,和质量鉴定。检查了CHE率的长期趋势,并采用亚组分析和荟萃回归分析探讨与CHE相关的因素。
UNASSIGNED:共纳入118项符合条件的研究,1,771,726名参与者。从2000年到2020年,中国的整体CHE率为25.2%(95%CI:23.4%-26.9%)。在普通人群中,CHE比率继续从2000年的13.0%上升到2020年的32.2%。城市地区的CHE率高于农村地区,西部比东北部高,东方,中部地区,老年人比非老年人,低收入群体比非低收入群体,在癌症患者中,慢性传染病,和心脑血管疾病(CCVD)比非慢性病组,在NCMS人群中,URBMI和UEBMI人群中。多元荟萃回归分析发现,低收入人群,癌症,CCVD,未指明的医疗保险类型,定义1和定义2与CHE率相关,而其他因素均无显著相关性。
未经授权:在过去的二十年中,中国的CHE率一直在上升。卫生支出的持续上升可能是CHE率上升的重要原因。年龄,收入水平,和健康状况影响CHE率。因此,有必要找到满足居民医疗需求的方法,同时,控制我国卫生支出的不合理快速增长。
To 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.
The 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.
A 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.
In 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.