Basic information about CCE of different age groups in Xinjiang in 2016
In 2016, the CCE in Xinjiang was 50.05 billion Chinese Yuan(CNY), accounting for 70.18% of current health expenditure, and accounting for 6.66% of GDP. And per capita CCE was 2366.56 CNY. The main CCE was for hospitalization. The hospitalization cost was 23.136 billion CNY, accounting for 46.23% of the CCE; the outpatient cost was 11.986 billion CNY, accounting for 23.95% of the CCE.
The results of CCE for people of different ages showed that the CCE decreased with age increasing from 0 to 14 years group. From 15 to 54 years group, the CCE continued to increase with age, reaching the highest expenditure in the 50–54 age group. Over the 55 years group, the CCE had declined with age increasing. Different ages consumed different degrees of health resources, so expenditure also changes with age (Table 1).
Comparing the proportion of the resident population with the proportion of CCE in each age group, it was found that the proportion of CCE for the people under 64 was lower than the proportion of the population, especially for those under 14 years old. The proportion of CCE for people over 65 was significantly higher than the proportion of their population, indicating that the elderly population consumes more medical resources (Fig. 1).
Table 1. The cost of treatment in Xinjiang by age group in 2016
Age
|
Total/
Billion CNY
|
Ratio/%
|
Outpatient/
billion CNY
|
Ratio/%
|
Intpatient/
billion CNY
|
Ratio/%
|
0~
|
2.46
|
4.92
|
0.75
|
4.42
|
1.71
|
5.18
|
5~
|
1.32
|
2.64
|
0.78
|
4.55
|
0.55
|
1.66
|
10~
|
0.80
|
1.60
|
0.44
|
2.55
|
0.37
|
1.11
|
15~
|
0.97
|
1.97
|
0.47
|
2.73
|
0.52
|
1.58
|
20~
|
1.52
|
3.04
|
0.68
|
4.00
|
0.84
|
2.53
|
25~
|
2.69
|
5.38
|
1.18
|
6.90
|
1.51
|
4.59
|
30~
|
2.73
|
5.46
|
1.18
|
6.89
|
1.56
|
4.72
|
35~
|
2.75
|
5.50
|
1.10
|
6.45
|
1.65
|
5.00
|
40~
|
3.98
|
7.95
|
1.46
|
8.56
|
2.52
|
7.63
|
45~
|
4.86
|
9.71
|
1.68
|
9.81
|
3.19
|
9.66
|
50~
|
5.09
|
10.18
|
1.71
|
10.02
|
3.38
|
10.26
|
55~
|
4.11
|
8.21
|
1.24
|
7.28
|
2.87
|
8.69
|
60~
|
4.37
|
8.73
|
12.55
|
7.35
|
3.11
|
9.44
|
65~
|
3.74
|
7.47
|
0.96
|
5.61
|
2.78
|
8.44
|
70~
|
3.28
|
6.55
|
0.83
|
4.85
|
2.45
|
7.43
|
75~
|
2.94
|
5.88
|
0.73
|
4.29
|
2.21
|
6.70
|
80~
|
1.54
|
3.07
|
0.41
|
2.40
|
1.13
|
3.42
|
85~
|
0.66
|
1.33
|
0.18
|
1.03
|
0.49
|
1.48
|
90~
|
0.17
|
0.34
|
0.05
|
0.28
|
0.12
|
0.37
|
≥95
|
0.03
|
0.07
|
0.01
|
0.04
|
0.03
|
0.08
|
Total
|
50.05
|
100.00
|
17.08
|
100.00
|
32.97
|
100.00
|
Disease distribution of CCE for different age groups
According to the classification criteria of the main chapter of the ICD-10, the top five CCE in Xinjiang were circulatory system disease, respiratory system disease, digestive system disease, urogenital system disease, muscular and connective tissue diseases totaled 28.646 billion CNY. The total expenditure of the top five diseases accounted for 57.24%. The composition of diseases that consumes medical resources in different age groups is different. The highest CCE for respiratory diseases in people under 14 was 39.71%, followed by symptoms, signs and clinical and laboratory abnormalities and digestive diseases. From 15 to 64 years group the highest CCE for circulatory diseases was 16.06%, followed by respiratory diseases, digestive diseases and urogenital diseases. The highest CCE for people over 65 years group was circulatory diseases accounted for 34.55%, followed by respiratory diseases and tumors accounted for a relatively high proportion (Table 2).
Medical institutions distribution of CCE for different age groups
Among the analysis of the provision of medical service providers, the CCE in 2016 mainly occurred in hospitals, with a total of 38.245 billion CNY, accounting for 76.42% of CCE, of which general hospitals were the main, followed by traditional Chinese medical hospitals and specialized hospitals. The treatment expenses incurred in primary health care institutions was 10.953 billion CNY, accounting for 21.89% of treatment expenses, and the proportion incurred in outpatient institutions and maternal and child health care was relatively small. Medical service providers differ in the cost of treatment for people of different ages.
Table 2. Distribution of diseases by cost of treatment at different ages(%)
ICD-10
|
≤14
|
15~
|
≥65
|
Total
|
Circulatory system diseases
|
1.04
|
16.06
|
34.55
|
19.11
|
Respiratory system diseases
|
39.71
|
10.19
|
15.32
|
14.92
|
Digestive system diseases
|
7.90
|
9.82
|
7.37
|
9.06
|
Urogenital system diseases
|
3.07
|
9.08
|
4.34
|
7.33
|
Muscular and connective tissue diseases
|
1.38
|
7.81
|
6.55
|
6.83
|
Injury , poisoning and external causes
|
5.37
|
7.35
|
3.59
|
6.17
|
Endocrine, nutritional and metabolic disease
|
2.86
|
5.93
|
6.74
|
5.82
|
Tumor
|
1.20
|
5.37
|
8.43
|
5.68
|
Symptoms, signs, clinical and laboratory abnormalities
|
9.04
|
6.36
|
2.19
|
5.51
|
Mental and behavior disorders
|
0.69
|
4.28
|
1.78
|
3.28
|
Factors influencing health status
|
1.54
|
4.26
|
1.21
|
3.24
|
Infectious diseases and parasitic diseases
|
5.54
|
2.62
|
1.55
|
2.59
|
Nervous system diseases
|
3.69
|
2.14
|
1.89
|
2.19
|
Pregnancy , childbirth and puerperium diseases
|
0.04
|
3.16
|
0.00
|
2.06
|
Skin and subcutaneous tissue disease
|
2.31
|
2.27
|
0.83
|
1.89
|
Eye diseases
|
0.47
|
1.13
|
2.58
|
1.41
|
Blood diseases
|
2.01
|
0.77
|
0.51
|
0.80
|
Perinatal diseases
|
6.73
|
0.15
|
0.00
|
0.70
|
Congenital anomalies and chromosomal abnormalities
|
3.85
|
0.49
|
0.14
|
0.70
|
Ear diseases
|
1.31
|
0.61
|
0.38
|
0.61
|
Death
|
0.24
|
0.15
|
0.06
|
0.13
|
Total
|
100.00
|
100.00
|
100.00
|
100.00
|
The cost of treatment for people over 65 years of age was mainly in hospitals, accounting for 82.43%, while the proportion in primary health care institutions was small. The cost of treatment for people under 14 years of age was mainly in general hospitals. Followed by primary health care institutions, and then specialized hospitals. Among different types of hospitals, it was found that the treatment cost of those under 14 years of age was higher in specialist hospitals, while the treatment costs of older people were higher in traditional Chinese medical hospitals (Table 3).
Table 3. Distribution of medical service providers by age (%)
Medical service providers
|
≤14
|
15~
|
≥65
|
Total
|
Hospitals:
|
66.18
|
75.59
|
82.43
|
76.42
|
general hospital
|
43.68
|
59.06
|
63.56
|
58.76
|
traditional Chinese medical hospital
|
5.18
|
11.51
|
14.93
|
11.78
|
specialized hospital
|
17.32
|
5.02
|
3.95
|
5.88
|
Maternal and child care centers
|
0.00
|
0.03
|
0.00
|
0.02
|
Outpatient service institutions
|
2.46
|
1.92
|
0.69
|
1.67
|
Primary health agents
|
31.36
|
22.45
|
16.87
|
21.89
|
Total
|
100.00
|
100.00
|
100.00
|
100.00
|
Financing distribution of CCE for different age groups
Among the CCE of Xinjiang, in 2016, the total funding of public financing scheme was 31.368 billion CNY, accounting for 62.68% of CCE, of which government programs accounted for 28.13%, and social medical insurance programs accounted for 34.55%; followed by household health expenditures of 17.097 billion CNY, accounting for 34.16%; voluntary funding schemes account for 3.16% of CCE. Funding schemes for different ages are also different. The main source of funding for people under the age of 14 is family household health expenditure accounting for 47.82%, followed by government funding and social health insurance; while those over the age of 15 are mainly social health insurance, followed by slightly different sources of funding. The 15–64 year-old group is the government financing scheme, and over the 65-year-old group is the family health expenditure (Table 4).
Table 4. Distribution of funding options for treatment costs for different age groups (%)
Health financing
|
≤14
|
15-65
|
65≥
|
Total
|
|
Public financing scheme
|
49.72
|
70.17
|
68.15
|
62.68
|
|
Government financing scheme
|
34.40
|
27.65
|
22.34
|
28.13
|
|
Social health insurance
|
15.32
|
42.52
|
45.81
|
34.55
|
|
Voluntary financing scheme
|
2.47
|
3.47
|
3.53
|
3.16
|
|
Family health expenditure
|
47.82
|
26.36
|
28.32
|
34.16
|
|
Total
|
100.00
|
100.00
|
100.00
|
100.00
|