Journal of Racial and Ethnic Health Disparities

, Volume 5, Issue 6, pp 1381–1388 | Cite as

Ethnic Disparity in Annual Healthcare Expenditures for Type 2 Diabetes Mellitus in Ningxia, China

  • Xian Sun
  • Tippawan Liabsuetrakul
  • Xiaomin Xie
  • Ping Liu
  • Yuhong Zhang
  • Zhizhong Wang



The incidence of type 2 diabetes mellitus (T2DM) and its complications has been increasing worldwide with an increasing provision of long-term medications and health services. This study aimed to assess the healthcare costs for T2DM patients for vulnerable ethnic minority.


A cross-sectional study was conducted from October 13, 2016, to June 19, 2017, in two public hospitals in Ningxia, China. Eligible Hui and Han inpatients were recruited and interviewed. Ethnic disparities in annual healthcare expenditures for T2DM measured from a societal perspective and its associations of expenditures with other factors were analyzed by linear and quantile regressions.


Ethnic disparities in annual healthcare expenditures for T2DM were demonstrated, mainly reflecting differences in the cost of productivity loss. The quantile of annual healthcare expenditure showed significant ethnic disparities in T2DM patients with complications. At the 10th to 50th quantiles of healthcare expenditures, Hui patients had significantly lower expenditures than Han patients in both unadjusted and adjusted models. Non-significant difference in expenditures between Hui and Han patients was found at the 90th quantile of expenditure in the unadjusted model, but significantly higher expenditures for Hui patients were shown when adjusted for socioeconomic and clinical factors.


T2DM Hui patients faced significantly higher expenditures than Han patients when the costs of healthcare were high. Appropriate national policy considering the issue of ethnic minority should be further explored to improve health and subsidize economic burden for T2DM patients.


Ethnic disparity Annual healthcare expenditures Type 2 diabetes mellitus Quantile regression 



This study was part of the first author’s thesis in partial fulfillment of the requirements for a Ph.D. at Prince of Songkla University, Thailand. We thank Mr. Dave Patterson, the International Affairs Office, Faculty of Medicine, for English editing this manuscript.

Funding Information

Funding support was granted by the China Medical Board under the project of “A second collaborative program to improve the health research capacity of western medical universities in China (14-181)” through the Epidemiology Unit, Prince of Songkla University, and the office of Postgraduate School through the dissertation funding, Prince of Songkla University.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The research was approved by the Human Research Ethics Committee, Faculty of Medicine, Prince of Songkla University, and the Medical Ethics Committee, Ningxia Medical University. All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  1. 1.Department of Epidemiology and Health Statistics, Faculty of Public Health and ManagementNingxia Medical UniversityYinchuanChina
  2. 2.Epidemiology Unit, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
  3. 3.Endocrinology DepartmentFirst People’s Hospital of YinchuanYinchuanChina
  4. 4.Endocrinology DepartmentGeneral Hospital of Ningxia Medical UniversityYinchuanChina

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