Catastrophic health expenditures of households living with pediatric leukemia in China

Abstract

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.

Association between livelihood capital and catastrophic health expenditure among patients with critical illness: a cross-sectional study in rural Shandong, China

“…The key role of households’ economic status in CHE was consistent with studies in other countries. 24 39 In addition, increased real estate ownership was associated with reduced CHE at a significance level of 5%. Our analysis suggests that physical and financial capital significantly influence the livelihood strategy of rural households.…”

“…Economic status, which represents a household’s financial capital, was also found to influence CHE. 24 25 Moreover, some studies have highlighted the perceived benefit of increased social capital for rural. 26 Can livelihood capital reduce the vulnerability of rural families to disease risk?…”

A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer

“…In one cross-sectional study of 242 households living with pediatric leukemia patients in China, 43.3% were found to have medical expenses that they were unable to pay for. Of these households, 97.1% obtained financial support from relatives and friends and 44% incurred debt [ 49 ]. Under such circumstances, cancer could lead to self-blame on the part of the patient rather than facilitating post-traumatic growth.…”

Disparities in economic burden for children with leukemia insured by resident basic medical insurance: evidence from real-world data 2015–2019 in Guangdong, China

“…conducted a survey to understand the catastrophic health expenditures of families with pediatric leukemia patients. They found that the households covered by a single public health medical insurer were more likely to experience catastrophic health expenditure [ 29 ]. One explanation for this was the limited benefit package and low compensation rate.…”