Journal
NEUROLOGICAL SCIENCES
Volume 41, Issue 5, Pages 1211-1223Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-019-04146-1
Keywords
Myasthenia gravis; Epidemiology; Southern and northern Chinese population; Hospital records; Health insurance systems; Medical costs
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Funding
- National Natural Science Foundation of China [30870850, 81071002, 81773660, 81801249, 81371386]
- National Natural Science Foundation Key International (Regional) Cooperation Research Project [81620 108010]
- Clinical Study of 5010 Planned Project Sun Yat-sen University [2010 003]
- Science and Technology Planned Project of Guangdong in China [2007B16002039]
- 2018 Guangdong Province Foundation and Applied Basic Research Special Fund for PhD Research Project Initiation [CANSci (2017)1935]
- Guangdong Science and Technology Department [03/2018-12/2021]
- 2016 Pearl River Talents Scheme Fund (Overseas) [CANHum (2017)3]
- Human Resources and Social Security Department of Guangdong Province
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Objective This is the first cross-region epidemiological study of myasthenia gravis (MG) in China. We estimated the incidence, prevalence, and medical costs of MG in southern China and explored the differences between the southern and northern Chinese populations. Methods We collected and analyzed records from 20 hospitals in the southern city, Guangzhou, 13 hospitals in the northern city, Harbin, and two healthcare insurance systems: job based and residence based in Guangzhou during 2000-2017. Results (1) The estimated annual incidence of MG was 1.55-3.66 per 100,000, and the estimated prevalence of MG was 2.19-11.07 per 100,000 in southern China based on insurance records. (2) The proportion of hospitalized MG patients in the south-based hospital records was three times as high as that in the north-based hospital records. (3) Female MG prevalence was significantly higher than male MG prevalence in Guangzhou, while the similar gender difference in Harbin was not statistically significant due to higher variation in earlier years. (4) The average expense was $35-42 for each outpatient service and $2526-2673 for each hospitalization expense in the south. (5) Contrary to the increase of insurance-based estimate of MG prevalence, the proportion of hospitalized MG patients did not increase over the years, suggesting rising awareness and utilization of health insurance. Conclusions The southern MG population had a significantly higher prevalence and a lower response threshold to medication than the northern MG population. These results are calling for further investigations on the genetic, cultural, and environmental variations of the Chinese MG populations between north and south.
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