Int J Health Geogr. 2026 Jan 3. doi: 10.1186/s12942-025-00449-z. Online ahead of print.
ABSTRACT
BACKGROUND: Chronic kidney disease (CKD) had become one of the increasingly serious public health problems in the world. This study aimed to explore the temporal-spatial distribution characteristics and associated socioeconomic factors of medical expenditures for rural patients with CKD in Fujian province from 2007 to 2016.
METHODS: The medical expenditures information of patients with CKD was abstracted from the database of New Rural Cooperative Medical Scheme. Geographically and temporally weighted regression model was used to analyze the associations between per capita annual medical expenditures and six socioeconomic factors at the county level.
RESULTS: The number of rural patients with CKD who visited in medical institutions increased from 3,099 in 2007 to 19,803 in 2016. The total and per capita medical expenditures of rural patients with CKD increased to 545.4 million yuan and 27,539.7 yuan in 2016, respectively. The ratio of per capita out-of-pocket expenses to per capita disposable income decreased from 108.5% in 2007 to 63.2% in 2016. The top 10% of patients with the highest total medical expenditures account for 31.2% ~ 52.5% of total medical expenditures from 2007 to 2016. The counties with high per capita annual medical expenditures mainly concentrated in the southern region and Longyan city. In which, the per capita annual medical expenditures were negatively associated with the percentage of female patients and number of health technicians per 10,000 persons, and positively associated with the percentage of patients who aged ≥ 60 years, percentage of patients whose length of stay > 10 days, per capita annual disposable income and number of beds per 10,000 persons.
CONCLUSIONS: The out-of-pocket ratio of rural patients with CKD decreased, but suffering from CKD was still catastrophic. The distribution of medical expenditures in rural residents was uneven and there was temporal-spatial heterogeneity in the associations between per capita annual medical expenditures and socioeconomic factors. It is necessary to improve the awareness and health literacy of residents, systematically carry out CKD screening program in high-risk populations, incorporate CKD into the National Basic Public Health Service Program and increase the number of health technicians which could effectively delay the disease progression and reduce medical expenses.
PMID:41485013 | DOI:10.1186/s12942-025-00449-z
