Effect of an outpatient copayment scheme on health outcomes of hypertensive adults in a community-managed population in Xinjiang, China

Hongpo Yin, Xiaochen Ma, Yanli He, Rujiang Liang, Yongxin Wang, Mei Zhang, Lu Mao and Mingxia Jing

PLOS ONE, 2020, vol. 15, issue 9, 1-16

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.

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0238980

DOI: 10.1371/journal.pone.0238980

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