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

Abstract

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.

Interpretation of China’s 2017 health expenditure: a latent profile analysis of panel data

“…42 As hospital level had a significant impact on the total health expenditure, the mean total cost in high-level hospitals towers lower-level ones. 43 However, very high health spending has not transformed into better access to quality care for all populations. 44 Broader policy development may promote optimal allocation of medical resources, 45 which implies that differences between the profiles in this study could ultimately be used for directing more resources to provinces belonging to the high county and township profile.…”

Estimated annual prevalence, medical service utilization and direct costs of lung cancer in urban China

“…Sporadic studies on the economic burden of lung cancer in China were carried out for specific regions, such as Beijing and Guangxi, or based on data with poor representativeness, comprising only a few hospitals, making it difficult to draw nationwide conclusions 9,12‐14 . The estimated average cost per lung cancer inpatient admission ranged from US$2220 to US$4612, with the estimated mean medical expenditure within 1 year after lung cancer diagnosis US$9788 9,13,14 . Using data from secondary, tertiary general and specialized cancer hospitals, Cai et al estimated the direct medical costs of lung cancer treatments in China of RMB24.3 billion 15 .…”

Disparities in end-of-life care, expenditures, and place of death by health insurance among cancer patients in China: a population-based, retrospective study

“…Several randomized trials among end-stage cancer patients showed that earlier palliative care could lead to improved quality of life and less aggressive care [ 11 , 12 ]. Despite the nationwide strategic procurement for cancer care in China, historical studies revealed that expenditures per admission among cancer patients varied by cancer type and health insurance [ 13 , 14 ]. In other words, higher socioeconomic status (SES) led to higher expenditures [ 3 ].…”

“…Fragmented health insurance schemes have caused inequitable access to healthcare [ 26 ]. Previous studies showed disparities in reimbursement or expenditures for tuberculosis healthcare services [ 27 ], for cancer patients [ 13 ] and for the elderly [ 28 ]. Moreover, as the current payment system is oriented towards a curative approach, physicians tend to provide more aggressive care, which leads to more curative treatment and later hospice enrolment [ 8 ].…”