Rural Versus Urban Patients: Benchmarking the Outcomes of Patients with Acute Myocardial Infarction in Shanxi, China from 2013 to 2017

Miao Cai, Echu Liu and Wei Li
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Miao Cai: Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA
Echu Liu: Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA
Wei Li: Dongfang College, Zhejiang University of Finance and Economics, Hangzhou 314408, China

IJERPH, 2018, vol. 15, issue 9, 1-16

Abstract: Rural-urban disparity in China attracts special international attention in view of the imbalance of economic development between rural and urban areas. However, few studies used patient level data to explore the disparity of health outcomes between rural and urban patients. This study aims to evaluate the trend of health outcomes between rural and urban patients hospitalized with acute myocardial infarction (AMI) in China. Using an electronic medical records (EMRs) database in Shanxi, China, we identified 87,219 AMI patients hospitalized between 2013 and 2017. We used multivariable binary logistic regressions and two-part models to estimate the association between region of origin (rural/urban) and two outcomes, in-hospital mortality and out-of-pocket (OOP) expenses. Rural patients were associated with lower in-hospital mortality and the adjusted Odds Ratios (ORs) were 0.173, 0.34, 0.605, 0.522, 0.556 ( p -values < 0.001) from 2013 to 2017, respectively. For the OOP expenses, rural patients were experiencing increasing risk of having OOP expenses, with the ORs of 0.159, 0.573, 1.278, 1.281, 1.65. The coefficients for the log-linear models in the five years were 0.075 ( p = 0.352), 0.61, 0.565, 0.439, 0.46 ( p -values < 0.001). Policy makers in China should notice and narrow the gap of health outcomes between rural and urban patients.

Keywords: rural-urban disparity; in-hospital mortality; out-of-pocket expense; acute myocardial infarction; electronic medical records (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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