Effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, China
Hypertension remains the leading risk factor for death and disability in China, and the ability of hypertensive patients to pay for outpatient care and medication has become a critical issue. To report the effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a commun...
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| description | Hypertension remains the leading risk factor for death and disability in China, and the ability of hypertensive patients to pay for outpatient care and medication has become a critical issue. To report the effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, we compared changes in outcomes between insured and uninsured groups from baseline to the first follow-up appointment in a community-managed hypertensive population and evaluated these changes based on propensity score matching and the difference-in-difference method. A total of 1,095 individuals in a community-managed hypertension population were selected for investigation at baseline, among which 805 (73.5%) had follow-up data and 749 (68.4%) were included in our analysis. After accounting for the self-reported severity of hypertension and individual characteristics, there were statistically significant improvements in drug treatment of hypertension and self-reported health. We also found increases in drug treatment for hypertension between groups, after correcting for confounding variables (Odds Ratio, OR 8.05, 95% Confidence interval, CI, 1.31-49.35), and in self-reported health between groups after correcting confounders (OR 1.96, 95% CI, 1.12 to 3.42). Adjusted estimates (confounding variables) were corrected for age, sex, income, marital status, education level, employment, family size, self-reported severity of hypertension, course of hypertension, and number of medications. As a result, decreased outpatient copayment was associated with an increase in antihypertensive treatment coverage, and an improvement in self-reported health among community-managed hypertensive populations in Xinjiang, China. |
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To report the effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, we compared changes in outcomes between insured and uninsured groups from baseline to the first follow-up appointment in a community-managed hypertensive population and evaluated these changes based on propensity score matching and the difference-in-difference method. A total of 1,095 individuals in a community-managed hypertension population were selected for investigation at baseline, among which 805 (73.5%) had follow-up data and 749 (68.4%) were included in our analysis. After accounting for the self-reported severity of hypertension and individual characteristics, there were statistically significant improvements in drug treatment of hypertension and self-reported health. We also found increases in drug treatment for hypertension between groups, after correcting for confounding variables (Odds Ratio, OR 8.05, 95% Confidence interval, CI, 1.31-49.35), and in self-reported health between groups after correcting confounders (OR 1.96, 95% CI, 1.12 to 3.42). Adjusted estimates (confounding variables) were corrected for age, sex, income, marital status, education level, employment, family size, self-reported severity of hypertension, course of hypertension, and number of medications. As a result, decreased outpatient copayment was associated with an increase in antihypertensive treatment coverage, and an improvement in self-reported health among community-managed hypertensive populations in Xinjiang, China.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0238980</identifier><identifier>PMID: 32915916</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adults ; Ambulatory care ; Analysis ; Antihypertensives ; Blood pressure ; Care and treatment ; Chronic illnesses ; Confidence intervals ; Cost control ; Family size ; Finance ; Health care costs ; Health care policy ; Health insurance ; Hypertension ; Medicaid ; Medicine ; Medicine and Health Sciences ; Patient outcomes ; Patients ; Population ; Public health ; Questionnaires ; Risk analysis ; Risk factors ; Rural areas ; Sample size ; Social Sciences ; Statistical analysis ; Surveys ; Uninsured people</subject><ispartof>PloS one, 2020-09, Vol.15 (9), p.e0238980-e0238980</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Yin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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To report the effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, we compared changes in outcomes between insured and uninsured groups from baseline to the first follow-up appointment in a community-managed hypertensive population and evaluated these changes based on propensity score matching and the difference-in-difference method. A total of 1,095 individuals in a community-managed hypertension population were selected for investigation at baseline, among which 805 (73.5%) had follow-up data and 749 (68.4%) were included in our analysis. After accounting for the self-reported severity of hypertension and individual characteristics, there were statistically significant improvements in drug treatment of hypertension and self-reported health. 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As a result, decreased outpatient copayment was associated with an increase in antihypertensive treatment coverage, and an improvement in self-reported health among community-managed hypertensive populations in Xinjiang, China.</description><subject>Adults</subject><subject>Ambulatory care</subject><subject>Analysis</subject><subject>Antihypertensives</subject><subject>Blood pressure</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Confidence intervals</subject><subject>Cost control</subject><subject>Family size</subject><subject>Finance</subject><subject>Health care costs</subject><subject>Health care policy</subject><subject>Health insurance</subject><subject>Hypertension</subject><subject>Medicaid</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Population</subject><subject>Public 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one</jtitle><date>2020-09-11</date><risdate>2020</risdate><volume>15</volume><issue>9</issue><spage>e0238980</spage><epage>e0238980</epage><pages>e0238980-e0238980</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Hypertension remains the leading risk factor for death and disability in China, and the ability of hypertensive patients to pay for outpatient care and medication has become a critical issue. To report the effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, we compared changes in outcomes between insured and uninsured groups from baseline to the first follow-up appointment in a community-managed hypertensive population and evaluated these changes based on propensity score matching and the difference-in-difference method. A total of 1,095 individuals in a community-managed hypertension population were selected for investigation at baseline, among which 805 (73.5%) had follow-up data and 749 (68.4%) were included in our analysis. After accounting for the self-reported severity of hypertension and individual characteristics, there were statistically significant improvements in drug treatment of hypertension and self-reported health. We also found increases in drug treatment for hypertension between groups, after correcting for confounding variables (Odds Ratio, OR 8.05, 95% Confidence interval, CI, 1.31-49.35), and in self-reported health between groups after correcting confounders (OR 1.96, 95% CI, 1.12 to 3.42). Adjusted estimates (confounding variables) were corrected for age, sex, income, marital status, education level, employment, family size, self-reported severity of hypertension, course of hypertension, and number of medications. As a result, decreased outpatient copayment was associated with an increase in antihypertensive treatment coverage, and an improvement in self-reported health among community-managed hypertensive populations in Xinjiang, China.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32915916</pmid><doi>10.1371/journal.pone.0238980</doi><tpages>e0238980</tpages><orcidid>https://orcid.org/0000-0001-7928-1260</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Ambulatory care Analysis Antihypertensives Blood pressure Care and treatment Chronic illnesses Confidence intervals Cost control Family size Finance Health care costs Health care policy Health insurance Hypertension Medicaid Medicine Medicine and Health Sciences Patient outcomes Patients Population Public health Questionnaires Risk analysis Risk factors Rural areas Sample size Social Sciences Statistical analysis Surveys Uninsured people |
| title | Effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, China |
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