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

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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)

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.

Suggested Citation

  • Miao Cai & Echu Liu & Wei Li, 2018. "Rural Versus Urban Patients: Benchmarking the Outcomes of Patients with Acute Myocardial Infarction in Shanxi, China from 2013 to 2017," IJERPH, MDPI, vol. 15(9), pages 1-16, September.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:9:p:1930-:d:167834
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    References listed on IDEAS

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    1. Hartley, D., 2004. "Rural health disparities, population health, and rural culture," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1675-1678.
    2. Padmore Adusei Amoah & Joseph Edusei & David Amuzu, 2018. "Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations," IJERPH, MDPI, vol. 15(5), pages 1-15, May.
    3. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 577-615.
    4. Pingali, Prabhu, 2007. "Westernization of Asian diets and the transformation of food systems: Implications for research and policy," Food Policy, Elsevier, vol. 32(3), pages 281-298, June.
    5. Martin Gaynor & Rodrigo Moreno-Serra & Carol Propper, 2013. "Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 134-166, November.
    6. Riva, Mylene & Curtis, Sarah & Gauvin, Lise & Fagg, James, 2009. "Unravelling the extent of inequalities in health across urban and rural areas: Evidence from a national sample in England," Social Science & Medicine, Elsevier, vol. 68(4), pages 654-663, February.
    7. Yen-Han Lee & Mack Shelley & Ching-Ti Liu & Yen-Chang Chang, 2018. "Assessing the Association of Food Preferences and Self-Reported Psychological Well-Being among Middle-Aged and Older Adults in Contemporary China-Results from the China Health and Nutrition Survey," IJERPH, MDPI, vol. 15(3), pages 1-13, March.
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