Health care utilization for patients with stroke: a 3-year cross-sectional study of China’s two urban health insurance schemes across four cities

Abstract Background Stroke is a devastating disease and major cause of death disability in China. While existing studies focused mainly on differences stroke patients’ health care utilization by insurance type, this study assesses whether medical costs differed type across four cities Methods A 5% random sample from the 2014–2016 China Urban Employees’ Basic Medical Insurance (UEBMI) Residents’ (URBMI) claims data were collected cities, Beijing, Shanghai, Tianjin, Chongqing. Descriptive statistics ordinary least squares regression employed to analyze data. Results We found that healthcare inpatient outpatient expenses varied more city-specific than they did between UEBMI URBMI schemes. For example, median Beijing (RMB500.2) significantly higher patients Shanghai (RMB260.8), Tianjin (RMB240.8), Chongqing (RMB293.0), had (RMB356.9) (RMB233.4) (RMB211.0), which (RMB156.2). Patients 66.4% (95% CI: − 0.672, 0.649) fewer visits, 13.0% 0.144, 0.115) 34.2% 0.366, 0.318) shorter length stay Beijing. The divergence average out-of-pocket (OOP) was also greater UEMBI-URBMI mean difference. Conclusions Significant reflected inequalities access. fragmented social schemes should be consolidated provide different equal financial protection benefit packages improve equity patient access care.