A new study has found that families in China face considerable economic hardship following stroke, and it is not uncommon for health care costs to push families below the poverty line. The large study shows over 70% of stroke survivors in China experience a catastrophic impact on their financial situation due to loss of income and cost of health care.
The nationwide study, conducted by Australian and Chinese researcher's and published in Stroke – The Journal of the American Heart Association, reveals that more than one-third of stroke patients in China are pushed below the poverty line, due to out-of-pocket expenses for their care. Over 30% of the total household income of a stroke patient is dedicated to ongoing health care payments. The results strongly support the current health system reform which includes expanding health insurance coverage to all Chinese citizens.
"Stroke is the most common single cause of death in China, which has contributed to a rising economic burden from health care costs. This study provides the first true picture of the economic effects of stroke on families, showing that stroke imposes catastrophic financial pressure, with many at risk of impoverishment," says author Dr WU Yangfeng Director of The George Institute, China.
Those worst affected financially by stroke are main income earners without health insurance, with up to 60% of health care expenditure financed from out-of-pocket payments. According to the new study, health insurance in China is beneficial and provides protection for patients against such financial effects.
Lead author Dr Emma Heeley, The George Institute explains, "Health insurance can give protection from the financial strain of experiencing a stroke in China, provided there is a high enough level of cover, which is around 75%. Given the rate stroke and chronic disease is increasing, there is a strong need for accelerating initiatives to expand health insurance coverage in both urban and rural settings in China and other developing countries."
Authors note that patients with health insurance still incur some costs that are not covered (initial co-payment and medication costs), but emphasise that health insurance is a step in the right direction. Health insurance schemes were introduced in China in 1998, with coverage provided to employees of state enterprises and some areas of the private sector. The authors encourage expansion of health coverage particularly among women, low-income earners and rural communities.
Currently the Chinese Government is launching a nationwide health system reform to improve the health of China's 1.3 billion residents by 2020. "The key to this round of health system reform is to increase government spending on health and commit to health insurance for the whole population, including people in rural areas and non-workers," added Dr Heeley.
Researchers studies almost 5000 stroke patients for five months across 62 hospitals in China, recording information on income and health care expenditure. The study (ChinaQUEST) was supported by grants from the Macquarie Bank Foundation, The George Foundation, and Astra Zeneca Pharmaceutical China.
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