Medical expenses of urban Chinese patients with stomach cancer during 2002-2011: a hospital-based multicenter retrospective study.

Autor: Sun XJ; School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China., Shi JF; Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. shijf@cicams.ac.cn., Guo LW; Department of Cancer Epidemiology, Henan Office for Cancer Control and Research, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China., Huang HY; Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China., Yao NL; School of Health Care Management (key Lab of Health Economics and Policy, National Health Commission), Shandong University, Jinan, China.; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908, USA., Gong JY; Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China., Sun YW; Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China., Liu GX; Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China., Mao AY; Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China., Liao XZ; Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, China., Bai YN; Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China., Ren JS; Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China., Zhu XY; Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.; Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China., Zhou JY; Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China., Mai L; Department of Institute of Tumor Research, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China., Song BB; Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China., Liu YQ; Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China., Zhu L; Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China., Du LB; Zhejiang Office for Cancer Control and Research, Zhejiang Cancer Hospital, Hangzhou, China., Zhou Q; Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, China., Xing XJ; Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China., Lou PA; Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China., Sun XH; Ningbo Clinical Cancer Prevention Guidance Center, Ningbo NO.2 Hospital, Ningbo, China., Qi X; Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China., Wang Y; Department of Economic Operation, Kailuan General Hospital, Tangshan, China., Cao R; Department of Health Policy and Economic Research, Guangdong Provincial Institute of Public Health, Guangzhou, China., Ren Y; Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China., Lan L; Institute of Chronic disease prevention and control, Harbin Center for Disease Control and Prevention, Harbin, China., Zhang K; Department of Cancer Prevention, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., He J; Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China., Wang JL; Shandong Academy of Medical Sciences, Shandong Provincial Cancer Hospital Affiliated to Shandong University, Jinan, 250117, China. wangjialin6681@sina.com., Dai M; Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2018 Apr 17; Vol. 18 (1), pp. 435. Date of Electronic Publication: 2018 Apr 17.
DOI: 10.1186/s12885-018-4357-y
Abstrakt: Background: In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients' medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients' medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends.
Methods: The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002-2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient.
Results: The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses.
Conclusions: The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China.
Databáze: MEDLINE
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