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Table 4 Determinants of the amount of OOPE for outpatient and inpatient services from multilevel regression analysis

From: Temporal trends and variation in out-of-pocket expenditures and patient cost sharing: evidence from a Chinese national survey 2011–2015

 

Outpatient

Inpatient

 

Log of OOPE

Log of OOPE for Prescription drugs

Log of OOPE

Log of OOPE for Prescription drugs

 

Regression coefficient

P value

Regression coefficient

P value

Regression coefficient

P value

Regression coefficient

P value

Insurance type (ref: no insurance)

 NCMS

− 0.094(− 0.339, 0.152)

0.455

− 0.071(− 0.295, 0.152)

0.532

− 0.08(− 0.427, 0.267)

0.652

− 0.065(− 0.443, 0.314)

0.738

 URBMI

0.012(− 0.312, 0.337)

0.941

0.111(− 0.186, 0.408)

0.465

− 0.021(− 0.454, 0.412)

0.925

− 0.065(− 0.538, 0.408)

0.788

 UEBMI

− 0.338(− 0.642, − 0.035)

0.029

− 0.266(− 0.544, 0.011)

0.060

− 0.002(− 0.401, 0.398)

0.993

0.035(− 0.4, 0.469)

0.876

 Others

−1.173(− 1.626, − 0.72)

< 0.001

−1.333(− 1.761, − 0.905)

< 0.001

−1.101(− 1.686, − 0.516)

< 0.001

− 0.347(− 0.991, 0.298)

0.292

PCE (ref: lowest 20%)

 Lower 20%

−0.141(− 0.306, 0.024)

0.093

− 0.048(− 0.199, 0.104)

0.538

0.115(− 0.14, 0.371)

0.376

−0.085(− 0.366, 0.197)

0.556

 Middle 20%

0.092(−0.07, 0.254)

0.264

0.081(−0.067, 0.23)

0.283

0.182(− 0.066, 0.43)

0.151

0.097(−0.177, 0.372)

0.486

 Higher 20%

0.112(−0.051, 0.275)

0.178

0.131(−0.018, 0.28)

0.085

0.493 (0.255, 0.732)

< 0.001

0.222(−0.04, 0.484)

0.097

 Highest 20%

0.391 (0.226, 0.556)

< 0.001

0.361 (0.21, 0.512)

< 0.001

0.759 (0.523, 0.995)

< 0.001

0.326 (0.066, 0.586)

0.014

Employment status (ref: not working)

 Retired

−0.156(− 0.712, 0.4)

0.582

−0.102(− 0.611, 0.408)

0.696

0.202(− 0.402, 0.806)

0.513

− 0.466(−1.127, 0.195)

0.167

 Working

− 0.444(− 0.998, 0.109)

0.116

−0.407(− 0.915, 0.1)

0.116

−0.158(− 0.765, 0.448)

0.608

−0.739(− 1.401, − 0.077)

0.029

Education (ref: primary school or below)

 Secondary school

− 0.001(− 0.13, 0.128)

0.988

0.011(− 0.107, 0.129)

0.859

−0.096(− 0.271, 0.079)

0.282

0.071(− 0.115, 0.257)

0.456

 College and above

−0.802(− 1.275, − 0.328)

0.001

−0.488(− 0.941, − 0.036)

0.035

−0.056(− 0.654, 0.541)

0.853

−0.78(− 1.42, − 0.14)

0.017

Age (ref: 45–54 years)

 55–64

− 0.13(− 0.257, − 0.002)

0.046

−0.108(− 0.224, 0.008)

0.069

− 0.163(− 0.354, 0.027)

0.093

−0.162(− 0.368, 0.043)

0.121

 65–74

− 0.208(− 0.361, − 0.056)

0.008

−0.145(− 0.285, − 0.005)

0.042

−0.425(− 0.64, − 0.21)

< 0.001

−0.356(− 0.588, − 0.124)

0.003

 75 and above

−0.482(− 0.727, − 0.237)

< 0.001

−0.381(− 0.608, − 0.154)

0.001

−0.74(− 1.033, − 0.447)

< 0.001

−0.498(− 0.814, − 0.181)

0.002

Gender (ref: male)

 Female

0.036(−0.071, 0.143)

0.508

0.021(−0.077, 0.119)

0.680

−0.129(− 0.273, 0.016)

0.081

−0.106(− 0.261, 0.048)

0.177

Marital (ref: single or divorce or widowed)

 Married or cohabitated

0.212 (0.066, 0.357)

0.004

0.075(−0.059, 0.209)

0.273

0.482 (0.283, 0.681)

< 0.001

0.145(−0.069, 0.359)

0.185

Comorbidity (ref: none)

 1 NCD

0.268 (0.095, 0.44)

0.002

0.273 (0.115, 0.432)

0.001

0.159(−0.103, 0.421)

0.233

0.114(−0.172, 0.4)

0.435

 2 NCDs

0.417 (0.243, 0.59)

< 0.001

0.425 (0.265, 0.585)

< 0.001

0.071(−0.184, 0.326)

0.584

−0.005(− 0.283, 0.272)

0.971

  > 2 NCDs

0.46 (0.291, 0.628)

< 0.001

0.431 (0.276, 0.586)

< 0.001

0.129(−0.111, 0.369)

0.291

0.021(−0.24, 0.281)

0.877

Location (ref: urban)

 Rural

0.091(−0.061, 0.243)

0.240

0.049(−0.084, 0.183)

0.469

0.001(−0.184, 0.187)

0.988

−0.349(− 0.554, − 0.144)

0.001

GDP per capita (ref: low)

 Middle

−0.131(− 0.312, 0.05)

0.157

− 0.104(− 0.273, 0.064)

0.225

0.236(− 0.004, 0.476)

0.054

0.146(− 0.103, 0.395)

0.251

 High

− 0.208(− 0.669, 0.254)

0.378

−0.064(− 0.498, 0.371)

0.773

0.649 (0.094, 1.204)

0.022

0.605 (0.011, 1.2)

0.046

Year (ref: 2011)

 2013

0.212 (0.07, 0.354)

0.003

0.137 (0.006, 0.269)

0.041

−0.096(−0.297, 0.104)

0.347

0.049(−0.174, 0.272)

0.664

 2015

0.447 (0.292, 0.602)

< 0.001

0.155 (0.011, 0.299)

0.035

−0.039(− 0.252, 0.175)

0.723

0.136(− 0.1, 0.371)

0.258

VPC, %

 Province

2.0%

 

3.0%

 

1.1%

 

0.3%

 

 City

2.3%

 

2.4%

 

0.6%

 

0.0%

 

 Community

1.8%

 

1.1%

 

1.9%

 

3.8%

 

 Individual

93.9%

 

93.5%

 

96.4%

 

95.9%

 
  1. Note:
  2. 95% CI was displayed in parentheses after the regression coefficient
  3. Respondents categorised in other insurance group were enrolled in insurance program other than the three major social health insurance, such as private insurance, government-funded insurance (Gong Fei) etc
  4. Abbreviation: UEBMI Urban Employee Basic Medical Insurance, URBMI Urban Resident Basic Medical Insurance, NCMS New Rural Cooperative Medical Scheme, Others government health care, private medical insurance and others, OOPE Out-of-pocket expenditure, PCE Per capita expenditure (Chinese Yuan), VPC Variance partition coefficient
  5. A likelihood ratio test was conducted to compare the fully adjusted model with null model with only random intercept and multivariable linear model. Fully adjusted multilevel model is preferred (P < 0.01)
  6. OOPE was log-transformed to normalise the distribution. Patients with zero OOPE were replaced by 1 for a mathematically meaningful log-transformation