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Outline
To investigate the incidence, intensity, and influencing factors of catastrophic health expenditure (CHE) among families of patients with phenylketonuria (PKU) in China and to assess the contributions of various factors to the inequity in CHE.
A cross-sectional survey was conducted among 263 PKU families from 24 provinces (autonomous regions, municipalities directly under the Central Government) in China, 2025. CHE was defined according to WHO recommended threshold of 40% of household capacity-to-pay. The incidence, mean gap (MG), and mean positive gap (MPG) of CHE were calculated. The concentration index and its decomposition were employed to evaluate equity, and logistic regression was adopted to identify influencing factors.
The overall incidence of CHE among PKU families was 52.09% (137/263). The incidence in rural families [69.57% (112/161)] was significantly higher than that in urban families [24.51% (25/102)]. Major risk factors for CHE included urban-rural disparity (OR = 11.18, 95%CI: 5.367–23.295) and the presence of complications (OR = 2.35, 95%CI: 1.122–4.941). The distribution of CHE demonstrated a pro-poor pattern, with a concentration index of –0.43 (95%CI: –0.52 to –0.33). The urban-rural disparity accounted for 65.53% of the total inequality.
Families of PKU patients in China face a high risk of CHE with substantial intensity and significant pro-poor inequality. The urban-rural disparity serves as the primary driver of this inequity.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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