Impact of reimbursement program on liver-related mortality in patients with chronic hepatitis B in Beijing, China.

OBJECTIVE: Since July 1, 2011 antiviral therapy for hepatitis B virus infection has been listed as a reimbursable expense for medical insurance in Beijing. This study aimed to assess the impact of this program on liver-related death for patients with chronic hepatitis B (CHB). METHODS: Profiles of patients with CHB discharged between January 2008 and December 2015 were retrieved from the Beijing hospital discharge database. Liver-related deaths in these patients occurring between January 2008 and December 2017 were retrieved by linking them to the death certification database. Liver-related mortality (number of deaths divided by the observed person-years) before and after this program was launched was calculated and compared. A Poisson regression was performed to assess the strength of association (risk ratio [RR]) between the reimbursement program and liver-related mortality. RESULTS: Information on 35 943 discharged patients (17 114 patients with non-cirrhotic and 18 829 with compensated cirrhotic CHB) was retrieved. Altogether 3 832 liver-related deaths during the 190 695 person-years were observed. After the reimbursement program was launched, liver-related mortality per 100 person-years dropped from 0.38% to 0.16% for patients with non-cirrhotic CHB, and from 4.03% to 3.39% for those with compensated cirrhosis. The program was associated with a lower risk of developing liver-related death for patients with non-cirrhotic CHB (RR 0.40, 95% confidence interval [CI] 0.30-0.52) and those with compensated cirrhosis (RR 0.84, 95% CI 0.78-0.89). CONCLUSION: Coverage of antiviral therapy by basic medical insurance reduced the risk of developing liver-related death for patients with non-cirrhotic and with compensated cirrhotic CHB.

[Decomposition of life expectancy among permanent residents of Beijing, 2000 - 2010].

OBJECTIVE: To analyze the change of life expectancy and the impact of mortality by age and causes of death on this issue among permanent residents of Beijing. METHODS: Abridged Life Table and Arriaga method were used to calculate and to decompose the changes on life expectancy by age and causes of death in 2000 - 2010. RESULTS: From 2000 - 2010, life expectancy under this studied population had an increase of 3.35 years. Most part of the increases (44.27%, 1.48 years) within the last 10 years could be explained by the decrease of mortality in the population at age ≥ 80. Both cerebrovascular and heart diseases were contributing the most to the increment of life expectancy while mortality of malignant tumors appeared a negative contributor to this increment. CONCLUSION: From 2000 to 2010, increment in life expectancy contributed to the decrease of mortality in the elderly and the decrease of mortalities on both cardio- and cerebro-vascular diseases. The decrease of life expectancy was mainly due to the increase of mortality related to malignant tumors.

[Characteristics of out-of-hospital acute coronary heart disease deaths of Beijing permanent residents at the age of 25 or more from 2007 to 2009].

OBJECTIVE: To analyze the characteristics of out-of-hospital acute coronary heart disease (CHD) deaths in Beijing permanent residents at the age of 25 or more from 2007 to 2009. METHODS: We analyzed the gender, age, geographical distribution, occupation, marital status and the extent of different education characteristics of out-of-hospital acute CHD deaths of the Beijing permanent residents at the age of 25 or more from 2007 to 2009 using the mortality information database from the Beijing Vital Registration Monitoring System. RESULTS: Of the total 41 732 acute CHD deaths, 30 159 (72.27%) died out of hospital and out-of-hospital mortality was 2.61 times higher than in-hospital mortality. Majority out-of-hospital death occurred in males (72.30%, 16 068/22 224), in 25 - 34 years old people (91.75%, 89/97), in residents living in remoter suburbs and counties (82.43%, 13 513/16 393), in rural population (89.50%, 10 017/11 192), in non-marital single (80.76%, 592/733) and in people less than five-years of schooling (83.95%, 11 388/13 565). Most out-of-hospital acute CHD death occurred at home (78.80%, 23 765/30 159). CONCLUSIONS: Out-of hospital acute CHD mortality is high in Beijing permanent residents at the age of 25 and over from 2007 to 2009. Male, 25 - 34 years old, living in outer suburbs and counties, rural population, non-marital single, and less education years are major risk factors for out-of-hospital acute CHD death.