How Has the Current Curative Expenditure of Noncommunicable Diseases Changed? Evidence From China in 2017-2019

Background: Noncommunicable diseases (NCDs) are the leading causes of morbidity and mortality worldwide. Understanding the distribution of diseases can provide a basis for policy formulation and intervention. This study analyses the current curative expenditure (CCE) of NCDs in China to provide health policy advice.Methods: Data were collected by multi-stage stratified random sampling from 2017-2019. The medical expenses of patients with NCDs were calculated based on “System of Health Accounts 2011”(SHA 2011), Analyze from funding sources, dimensions of institutional flow, and financing scheme. Linear regression analysis was conducted by controlling factors influencing hospitalization expenses. All analyses were performed by STATA 15.0.Results: 408 institutions and 8,104,233 valid items were included in the study. The CCE of NCDs was 14.205 billion China Yuan (CNY) in 2017, 15.914 billion CNY in 2018, and 18.055 billion CNY in 2019. More than 60% came from public financing. The proportion of family health financing continued to decline, reaching 31.16% in 2019. The expenditures were mainly in general hospitals, above 70%. Elderly patients account for the majority. Diseases of the circulatory system, Diseases of the digestive system, and Neoplasms were the main NCDs. Year, age, gender, length of stay, surgery, insurance, and institution level were the factors affecting hospitalization expenses.Conclusions: NCDs are the main CCE of diseases in China, and their resources are not allocated reasonably. To reduce the CCE of NCDs, the government needs to optimize resource allocation and rationalize institutional flows and functions.