Disparities in medical expenditure and outcomes among patients with intracranial hemorrhage associated with different insurance statuses in Southwestern China

Abstract

As the economic impact of intracranial hemorrhage (ICH) has not been well characterized before, the purpose of this study is to investigate the prognosis of ICH patients with different insurances in southwestern China. This study used hospital data from December 2005 to September 2009. All patients with a final discharge diagnosis of acute ICH were enrolled. Patients were divided by payer sources. Hospital expenditure, length of hospital stay (LOS) and outcome during hospitalization were analyzed. SAS 9.1 software was utilized for the Kruskal-Wallis test and multivariate logistic regression analysis. There were 1,091 adult subjects who met the inclusion criteria of ICH. Hospital costs were remarkably higher for local medical insurance beneficiaries than for the nonlocally insured group and the uninsured group. The locally insured group had the longest LOS compared to the uninsured and nonlocally insured groups. There were significant outcome differences between the locally insured and uninsured groups. However, we noted that locally insured patients seemed to have higher in-hospital mortality from ICH. In spite of acquiring insurance, these ICH subjects did not appear to have better outcomes. The results emphasize the need for improvement in health care policy. © 2011 Springer-Verlag/Wien.