1.Analysis on the hospitalization costs differences and its effects on health outcome among the stroke patients
Yingnan CAO ; Tianjia GUAN ; Jinlei LI ; Yimin QU ; Ban WANG ; Yuanli LIU
Chinese Journal of Health Policy 2016;9(5):54-60
Objective:The paper is designed to reveal differences in stroke patients'hospitalization costs crea-ted by different socioeconomic factors , health insurance and occupational background , and analyze those differences on health outcome .Methods:18879 cases of hospitalized patients with stroke in five tertiary hospitals from four prov-inces from 2011 to 2014 were included in the database .Descriptive statistics was used to describe patients'hospitali-zation costs and health outcome .Multiple linear regression model and logistic regression were used to evaluate the im-pact of insurance and occupation .Results:After controlling for patients'social characteristics , health risks , premise during hospitalization process and clinical characteristics of patients with free healthcare costs , the socialized medi-cine was charged 19.7% higher than the private ones ( P <0.001 ), the retired people and civil servants were charged 4.2%(P<0.001) and 2.9%(P=0.049) more than farmers.The socialized medicine was also associated with health outcome.The risk of death in patients with free medical care is (OR=4.901) compared with private pa-tients (95%CI 1.652~14.537), and the retired people had increased risk of death compared with farmers (OR=2 .145 , 95%CI 1 .287 ~3 .573 ) .Conclusions: Due to the impact of social background factors , some groups are found to have a higher level of expenses than their counterparts during hospitalization , but the more hospitalization costs are not spent the better the health outcome of stroke was achieved .
2.The association of health?related behavior and the risk of stroke in people with hypertension
Jian GUO ; Yuanli LIU ; Tianjia GUAN ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(2):223-228
Objective To investigate the association between the combination of different health?related behaviors and the risk of stroke in people with hypertension. Methods The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first?ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency?matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health?related behaviors (non?smoking, normal body mass index maintenance and physical activity) was obtained using standardized face?to?face questionnaires. Univariate analysis included t?test and Chi?square test. Multivariate analysis included unconditional logistic regression. Results There were 603 total stroke cases (1 909 controls) and 536 ischemic stroke cases (1 608 controls) in men with hypertension, and 600 total stroke cases (1 800 controls) and 534 ischemic stroke cases (1 602 controls) in women with hypertension. We found that women with three health?related behaviors had lower risk of total stroke ( OR=0.29, 95%CI : 0.11-0.79) and ischemic stroke ( OR=0.28, 95%CI : 0.10-0.77). Only the combination of non?smoking and physical activity was significantly associated with the decreased risk of total stroke ( OR=0.30, 95%CI : 0.11-0.78) and ischemic stroke ( OR=0.32, 95%CI : 0.12-0.87). We had not found significant association between the combination of different health?related behaviors and risk of total stroke and ischemic stroke (P>0.05) in men. Conclusion This study indicated that health?related behavior intervention might be more effectively to prevent stroke in women with hypertension, especially the smoking control and physical activity.
3.Gender?specific factors of ischemic stroke among atrial fibrillation patients
Jian GUO ; Tianjia GUAN ; Yuanli LIU ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(11):1136-1140
Objective To explore gender?specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients. Methods A case?control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first?ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency?matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population?attributable risk proportion [PARP, (95%CI) ] was calculated. Results The age of male subjects in the case group and control group were (65.26 ± 11.20) and (64.83 ± 11.08) years old, and that of females in two groups were (63.63 ± 10.40) and (63.93 ± 10.35) years old. According to the PARP (95%CI ), relevant factors of the onset of ischemic stroke in a descending sequence were hypertension history [35.63 (18.64-47.73) ], family history of stroke [28.70 (23.63-32.30) ]and physical inactivity [15.73 [5.62-23.06) ] among male AF patients,and family history of stroke (29.39 (24.21-33.08)), dyslipidemia (22.17 (2.26-36.45)) and smoking [2.09 (0.76-3.24) ] among female AF patients. Conclusion The relevant factors of ischemic stroke were different between male and female AF patients.
4.The association of health?related behavior and the risk of stroke in people with hypertension
Jian GUO ; Yuanli LIU ; Tianjia GUAN ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(2):223-228
Objective To investigate the association between the combination of different health?related behaviors and the risk of stroke in people with hypertension. Methods The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first?ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency?matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health?related behaviors (non?smoking, normal body mass index maintenance and physical activity) was obtained using standardized face?to?face questionnaires. Univariate analysis included t?test and Chi?square test. Multivariate analysis included unconditional logistic regression. Results There were 603 total stroke cases (1 909 controls) and 536 ischemic stroke cases (1 608 controls) in men with hypertension, and 600 total stroke cases (1 800 controls) and 534 ischemic stroke cases (1 602 controls) in women with hypertension. We found that women with three health?related behaviors had lower risk of total stroke ( OR=0.29, 95%CI : 0.11-0.79) and ischemic stroke ( OR=0.28, 95%CI : 0.10-0.77). Only the combination of non?smoking and physical activity was significantly associated with the decreased risk of total stroke ( OR=0.30, 95%CI : 0.11-0.78) and ischemic stroke ( OR=0.32, 95%CI : 0.12-0.87). We had not found significant association between the combination of different health?related behaviors and risk of total stroke and ischemic stroke (P>0.05) in men. Conclusion This study indicated that health?related behavior intervention might be more effectively to prevent stroke in women with hypertension, especially the smoking control and physical activity.
5.Gender?specific factors of ischemic stroke among atrial fibrillation patients
Jian GUO ; Tianjia GUAN ; Yuanli LIU ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(11):1136-1140
Objective To explore gender?specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients. Methods A case?control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first?ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency?matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population?attributable risk proportion [PARP, (95%CI) ] was calculated. Results The age of male subjects in the case group and control group were (65.26 ± 11.20) and (64.83 ± 11.08) years old, and that of females in two groups were (63.63 ± 10.40) and (63.93 ± 10.35) years old. According to the PARP (95%CI ), relevant factors of the onset of ischemic stroke in a descending sequence were hypertension history [35.63 (18.64-47.73) ], family history of stroke [28.70 (23.63-32.30) ]and physical inactivity [15.73 [5.62-23.06) ] among male AF patients,and family history of stroke (29.39 (24.21-33.08)), dyslipidemia (22.17 (2.26-36.45)) and smoking [2.09 (0.76-3.24) ] among female AF patients. Conclusion The relevant factors of ischemic stroke were different between male and female AF patients.
6.A Review of Comparative Studies on Exposure Levels of Air Pollutants Among Different Modes of Transportation in China's Cities
Yanqing GUO ; Man CAO ; Xueyan HAN ; Yu ZHANG ; Tianjia GUAN ; Yuanli LIU
Acta Academiae Medicinae Sinicae 2024;46(1):119-127
Urban traffic is closely related to the daily life of the public,and air pollution in the traffic microenvironment has become a public health problem that cannot be ignored.This paper reviews the comparative studies of air pollutant exposure levels among different modes of transportation in multiple cities in China.By com-paring the exposure levels of pollutants among different modes of transportation,this paper provides a reference for protecting the health of the public in daily transportation and selecting targeted control measures.
7. Gender-specific factors of ischemic stroke among atrial fibrillation patients
Jian GUO ; Tianjia GUAN ; Yuanli LIU ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(11):1136-1140
Objective:
To explore gender-specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients.
Methods:
A case-control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first-ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency-matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population-attributable risk proportion [PARP, (95
8. The association of health-related behavior and the risk of stroke in people with hypertension
Jian GUO ; Yuanli LIU ; Tianjia GUAN ; Baohua CHAO ; Longde WANG
Chinese Journal of Preventive Medicine 2019;53(2):223-228
Objective:
To investigate the association between the combination of different health-related behaviors and the risk of stroke in people with hypertension.
Methods:
The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first-ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency-matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health-related behaviors (non-smoking, normal body mass index maintenance and physical activity) was obtained using standardized face-to-face questionnaires. Univariate analysis included
9.The epidemiological characteristics and adherence to hypoglycemic agents of ischemic stroke patients with diabetes
Jian GUO ; Tianjia GUAN ; Longde WANG ; Baohua CHAO ; Yuanli LIU
Chinese Journal of Preventive Medicine 2021;55(8):952-957
Objective:To investigate the epidemiological characteristics and adherence to hypoglycemic agents of the ischemic stroke patients combined with diabetes.Methods:The study recruited 23 044 ischemic stroke cases from 2013-2015 screening period of China National Stroke Screening Survey. Standardized questionnaires were used to obtain information on demographic data, stroke history, the presence of influence factors, as well as the type of stroke, diagnosis date, frequency, chronic diseases history and hypoglycemic therapy. We used logistics model to investigate the possible risk factors of ischemic stroke combined with diabetes, and calculated the population attributable risk proportion ( PARP). We also investigate the adherence to hypoglycemic agents. Results:The mean age of 23 044 ischemic stroke patients was (64.99±9.42) years old, 50.91% were males (11 731). In ischemic stroke patients, 21.52% had diabetes. According to the results of logistics model, ischemic stroke patients with hypertension, dyslipidemia, atrial fibrillation or family history of stroke had higher risk to combine with diabetes, their Odds Ratios ( OR) were 2.18 (1.87-2.55), 1.99 (1.78-2.23), 1.64 (1.39-1.92) and 1.19 (1.06-1.33). Considering the prevalence of each influence factor in ischemic stroke patients, atrial fibrillation had the highest PARP (95% CI) of 62.65% (61.27%-63.76%). In ischemic stroke patients combined with diabetes, 70.73% (3 463/4 896) had taken hypoglycemic agents. Conclusion:There still were a large number of ischemic stroke patients combined with diabetes and a low rate of adherence to hypoglycemic agents.
10.The risk factors of first recurrence in ischemic stroke patients in different periods after first attack
Jian GUO ; Tianjia GUAN ; Longde WANG ; Baohua CHAO ; Yuanli LIU
Chinese Journal of Preventive Medicine 2021;55(9):1105-1113
Objective:To investigate the risk factors of first recurrence in ischemic stroke patients at different periods after first attack.Methods:The subjects were from the screening population of China National Stroke Screening Survey (CNSSS) from 2013 to 2015. The basic demographic information, stroke history, influencing factors and modified Rankin Scale (mRs) scores were collected by using standardized face-to-face questionnaires. A case-control study was conducted to investigate the risk factors of first recurrence in ischemic stroke patients who relapsed for the first time within 12 months, 24 months and 36 months as the case group and non-recurrent ischemic stroke patients as the control group. Further, the subjects were stratified into different subgroups by age, gender and urban-rural distribution to investigate the risk factors of first recurrence in different periods.Results:Diabetes ( OR=1.71, 95% CI: 1.08-2.71) and coronary heart disease ( OR=1.55, 95% CI: 1.09-2.19) were significantly associated with the risk of first recurrence within 12 months after the first onset of ischemic stroke. The diabetes was significantly associated with the risk of first recurrence within 24 months ( OR=1.94, 95% CI: 1.33-2.83) and 36 months ( OR=1.64, 95% CI: 1.15-2.34) after the first onset of ischemic stroke. With the increase of mRs score, the risk of first recurrence within 12 months, 24 months and 36 months in ischemic stroke patients increased significantly. In the same period, the risk factors of ischemic stroke recurrence differed in patients with different age, gender and urban-rural distribution. Conclusions:The risk factors of first recurrence in ischemic stroke patients are diverse at different periods after the first onset of ischemic stroke. In different subgroups, the risk factors of first recurrence and the strength of its corresponding association are also different.