Author

Fang BaFollow

Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Xi Chen

Abstract

The number of people in the world living with Alzheimer’s Disease and related dementias (ADRD) continues to rise rapidly, which places a substantial burden on people with dementia (PWD), their families, and the society. Such a burden has been rising faster in low-income and middle-income countries (LMIC) where around two-thirds of PWD live. While prior research documents dementia prevalence in China and indicates its large geographic disparities, no study to date has documented the national pattern of health care utilization, quality and costs in China. The absence of knowledge would largely impede the effective allocation of resources for combating dementia and targeted policy interventions in China. This study made the first attempt to document inpatient care utilization, quality, and costs for ADRD patients in China using a nationally representative inpatient database. We first summarized geographic disparities in dementia prevalence in China, which was compared with disparities in care utilization and outcomes among hospitalized patients. We then explored to what extent demographic factors, insurance generosity, comorbidities, hospital infrastructure may explain variations in inpatient care utilization, quality and costs for dementia patients. Our findings suggest gaps in health equity and efficiency for this fast-growing population of dementia patients. Our results inform future work to improve chronic disease management and health insurance coverage to achieve a more affordable and equitable financial burden for PWD.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2022

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