BACKGROUND: This study aims to evaluate the curative care expenditure (CCE) of Parkinson's disease (PD) under different comorbidity conditions to provide a reference basis for formulating health policies for PD.
METHODS: This study used a multi-stage stratified random sampling method to investigate 37,604 PD patients in 1,600 medical institutions in Sichuan, China, in 2019. Based on the System of Health Accounts 2011 (SHA2011), the scale of the CCE, financing schemes, institutional flows, and beneficiary groups of PD under different comorbidity conditions were calculated. Multiple linear regression model was used to analyze the factors influencing the hospitalization expenditure.
RESULTS: In 2019, the total CCE for PD in Sichuan was US$36.29 million, accounting for 0.11% of the province's total disease CCE and 0.005% of its gross domestic product (GDP) that year. Household out-of-pocket (OOP) payments (68.98% for outpatients and 42.26% for inpatients) and public financing schemes (30.69% for outpatients and 52.28% for inpatients) were the main sources of financing CCE. More than 80% of the CCE went to general hospitals, while less than 2% went to primary health-care institutions. As the comorbidity index increased, the CCE for PD exhibited an aging trend, with the low-, medium-, and high-comorbidity groups mainly concentrated in those in their fifties, those aged 60-79, and those over 80, respectively. The multiple linear regression analysis showed that the top three factors affecting hospitalization expenditure were the length of stay, surgery and institution level.
CONCLUSIONS: The CCE for PD is high, and individuals and families are the main bearers of health expenditures. It is recommended to optimize medical insurance policies, increase outpatient insurance coverage, and gradually increase the level of insurance benefits. Furthermore, it is necessary to explore multi-party collaboration to establish a diversified and multi-level medical security system for PD.
