Catastrophic health expenditure and its determinants in households with lung cancer patients in China: a retrospective cohort study

Abstract

Background Numerous studies have examined catastrophic health expenditures (CHE) worldwide, mostly focusing on general or common chronic populations, rather than particularly vulnerable groups. This study assessed the medical expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China. Methods During 2018–2019, a hospital-based multicenter retrospective survey was conducted in seven provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. CHE was measured according to the proportion of out-of-pocket (OOP) health payments of households on non-food expenditures. Chi-square tests and logistic regression analysis was adjusted to determine the factors that significantly influenced the likelihood of a household with lung cancer patient to incur in CHE. Results In total, 470 households with lung cancer patients were included in the analysis. Health insurance was shown to protect some households from the impact of CHE. Nonetheless, CHE incidence (78.1%) and intensity (14.02% for average distance and 22.56% for relative distance) were still relatively high among households with lung cancer patients. The incidence was lower in households covered by the Urban Employee Basic Medical Insurance (UEMBI) insurance, with higher income level and shorter disease course. Conclusion More attention is needed for CHE incidence among vulnerable populations in China. Households with lung cancer patients were shown to be more likely to develop CHE. Therefore, policy makers should focus on improving the financial protection and reducing the economic burden of this disease.

A systematic review of financial toxicity among cancer patients in China

“…After removing duplicates, 7466 studies remained for relevancy screening, and 662 remained for full-text review. Finally, 13 articles published in Chinese and reporting 12 studies [29][30][31][32][33][34][35][36][37][38][39][40][41] and 18 articles published in English [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] were included in the review. Fig.…”

“…Of the 30 included studies, only 13 38,41,42,[46][47][48][49]52,53,[56][57][58][59] clearly defined the inclusion criteria; only 7 42,46,48,50,52,53,56 described the study subjects and settings in detail; and 3 36,39,41 were rated as "unclear" for statistical analysis, as they did not describe how the categorical variables were assigned values or how dummy variables were set for polytomous variables, although their selection of statistical analysis method (multiple linear regression) was appropriate. Of the 25 analytical cross-sectional studies, 29,31,[34][35][36][37][38][39][40][41][45][46][47][48][49][50][51][52][53][54][55][56][57][58]…”

“…Twenty-one studies (70%) were published after 2016. [37][38][39][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] All 30 studies used a cross-sectional design, of which 26 were survey based, [30][31][32]34,35,[37][38][39][40][41][42][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] 2 were medical or insurance record based, 29,43 and 2 were both survey based and medical record based. 33,…”

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

“…In Germany, job incomes dropped more than one forth within one year after cancer diagnosis, whereas in China, belonging to UMICs, this thread can reach an entire year's worth of GDP per capita [34]. The highest incidence and relative extent of catastrophic healthcare expenditures appears to involve cancer patients and their families when they already belong to low-income groups [35][36][37].…”

Comprehensive analysis of a novel signature incorporating lipid metabolism and immune-related genes for assessing prognosis and immune landscape in lung adenocarcinoma

“…As the leading cause of cancer-related mortality among all malignant tumors, lung cancer still contributes to a heavy burden not only for patients but also for all of society ( 1 , 2 ). In China, the high prevalence of smoking and the risk of being exposed to second-hand smoke make the prevention and treatment of lung cancer grim ( 3 ).…”