How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on “System of Health Account 2011”

Zheng, Aiping; Duan, Wenjuan; Zhang, Lin; Xintong, Bao; Mao, Xiaoyun; Luo, Zhuojun; Jin, Feng

doi:10.1002/cam4.1590

Cited by 31 publications

(54 citation statements)

References 16 publications

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“…Cancer cost was predominant in people aged from 50 to 70. This supports existing evidence in China and consistent with epidemiological findings that most cancer incidence rates increase exponentially with aging . As for the expenditure pattern, we found that cost attributed to medication accounted a large proportion in both inpatient (37.7%) and outpatient care (64.6%) across all kinds of cancers.…”

Section: Discussionsupporting

confidence: 90%

Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

Yin

Man

et al. 2019

Cancer Medicine

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Background Cancer is a major public health issue worldwide. The cost of cancer care imposes a substantial economic burden on society and patient, but it has not been thoroughly studied in China. This study aimed to describe direct cost and cost elements of all cancer types by different beneficial characteristics. Methods The research was a retrospective observational study based on inpatient and outpatient records with a primary diagnosis of cancer from 31 hospitals in 2016. Total cost and cost per time were analyzed by cancer type, sources (prescription medicines, consumables fee for diagnosis and surgery, and other health services), and beneficial characteristics (gender and age). Results A total of 30 224 eligible inpatient admissions and 485 391 outpatient visits were identified during the study period. Inpatient care costs account for 58.6% cancer treatment costs. Nearly 70% of the total expenditure is spent on patients aged 50‐79 years. Lung cancer had the highest economic cost (15% of overall cancer costs), followed by breast cancer (12%), and colorectal cancer (10%). Anticancer drug cost accounted a large proportion in both inpatient (37.7%) and outpatient care (64.6%). The average cost per inpatient admission was estimated to be $4590.1 (5621.9), ranging from $1157.7 (1349.8) for testis cancer to $7975 (7343.9) for stomach cancer. The regression analyses revealed that length of hospital stay, cancer type, age, payment type, and hospital level were highly correlated with the expenditure per admission (P < 0.001). Conclusions The cancer care cost is substantial and varies with cancer type. Our findings provide important information for health service planning, allowing more efficient allocation of health resources for the care of people with cancer.

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Section: Discussionsupporting

confidence: 90%

Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

Yin

Man

et al. 2019

Cancer Medicine

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“…This proportion was similar to a recent study conducted, where the authors found the incidence of CHE for six types of cancers including esophageal, colon, gastric, liver, lung, and breast cancer to be 42.78%. 20 The prevalence of CHE was also similarly reported in prior studies conducted in Malaysia (47.8%), 24 South Korea (39.8%), 15 and eight Southeast Asian countries (48%). 19 However, this proportion was much lower than in another study conducted in China.…”

Section: Discussionsupporting

confidence: 75%

“…In addition, the threshold used to define CHE varied across the studies, ranging from 10%, 15 30% 19 and 40%. 20,21,24 In light of the possible shortcomings in previous studies, non-medical expenses and other sources of compensation, such as charity assistance, were included in the calculation of CHE in the current study. Nonetheless, results from both the current study and previous studies indicate that there is a potential risk for leukemia to result in significant financial and economic burden.…”

Section: Discussionmentioning

confidence: 99%

“…18 In the ASEAN Costs In Oncology (ACTION) study which covered eight counties in the Association of Southeast Asian Nations (ASEAN), findings revealed that over 75% of the patients with cancer experienced financial catastrophe within a year. 19 In China, two recent studies reported that the incidence of CHE resulting from cancer was 42.78% 20 and up to 95%, 21 with 40% as the threshold level. While these studies reveal the financial burden of cancer treatment on a household, existing literature on CHE has only been conducted in the adult cancer population.…”

Section: Introductionmentioning

confidence: 99%

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Catastrophic health expenditures of households living with pediatric leukemia in China

et al. 2020

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Background Leukemia can create a significant economic burden on the patients and their families. The objective of this study is to assess the medical expenditure and compensation of pediatric leukemia, and to explore the incidence and determinants of catastrophic health expenditure (CHE) among households with pediatric leukemia patients in China. Methods A cross‐sectional interview was conducted among households living with pediatric leukemia using a questionnaire in two tertiary hospitals. CHE was defined as out‐of‐pocket (OOP) payments that were greater than or equal to 40% of a household's capacity to pay (CTP). Chi‐square tests and logistic regression analysis were performed to identify the determinants of CHE. Results Among 242 households living with pediatric leukemia, the mean OOP payment for pediatric leukemia healthcare was $9860, which accounted for approximately 35.7% of the mean household's CTP. The overall incidence of CHE was 43.4% and showed a downward trend with the lowest income group at 69.0% to the highest income group at 16.1%. The logistic regression model found that medical insurance, frequency of hospital admissions, charity assistance, and income level were significant predictors of CHE. Conclusion The results revealed that pediatric leukemia had a significant catastrophic effect on families, especially those with lower economic status. The occurrence of CHE in households living with pediatric leukemia could be reduced by addressing income disparity. In addition, extending coverage and improving compensation from medical insurance could also alleviate CHE. Some other measures that can be implemented are to address the barriers of charity assistance for vulnerable groups.

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“…A reasonable health nancing system should focus on public nancings such as government and social medical insurance, and control the personal cash health expenditure (OOP) paid by the family to a lower level [17]. If the health nancing system relies too much on household health expenditures, it will easily lead to catastrophic expenditure or poverty due to illness [18]. Due to physical reasons, children's resistance is poor and they are more likely to get sick, which not only leads to the loss of children's health but also brings a huge cost of disease treatment.…”

Section: Discussionmentioning

confidence: 99%

How did the Beneficiary Groups of Curative Care Expenditure Distribute? Based on SHA 2011: A Case Study in Xinjiang Autonomous Region, China

Feng

Mao

et al. 2020

Preprint

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Background System of Health Accounts 2011 (SHA2011) not only meets the analysis of health policies but also increases the comparability of international health from expenditure. This study analyzes the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang based on SHA 2011, and provides references for making health policies. Methods A total of 352 sample health institutions were collected with multistage stratified random sampling method in Xinjiang. According to the accounting framework of the SHA 2011, the CCE distribution, institutional flow and disease distribution of different age groups were analyzed. Results In 2016, the CCE in Xinjiang was 50.05 billion Chinese Yuan (CNY), accounting for 70.18% of current health expenditure (CHE), 6.66% of GDP, and per capita CCE was 2366.56 CNY. People aged over 65 was the consumed major CCE, different diseases treatment costs have a different distribution in the age groups. Three types of diseases with the highest CCE were circulatory, respiratory and digestive system diseases. All of the beneficiary expenditure mainly occurred in hospitals, the proportion of primary health care institutions was relatively small. Family health expenditure accounts for a relatively high proportion, especially children aged 14 years old and below. Conclusion This study used SHA2011 to capture large data and analyzed from the newly added beneficiary dimension. The population had a heavy burden of medical financing, the allocation of medical resources was unreasonable, and the scale of primary medical institutions needs to be reasonably expanded. The financing plan for CCE needs to be optimized to decrease the medical burden of disease.

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How great is current curative expenditure and catastrophic health expenditure among patients with cancer in China? A research based on “System of Health Account 2011”

Cited by 31 publications

References 16 publications

Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

Catastrophic health expenditures of households living with pediatric leukemia in China

How did the Beneficiary Groups of Curative Care Expenditure Distribute? Based on SHA 2011: A Case Study in Xinjiang Autonomous Region, China

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