Direct inpatient costs and influencing factors for patients with rectal cancer with low anterior resection: a retrospective observational study at a three-tertiary hospital in Beijing, China

Chen, Zhishui; Leng, Jiahua; Guang-ying, Gao; Zhang, Lianhai; Yang, Yang

doi:10.1136/bmjopen-2018-023116

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…Compared with other treatments, complex surgical procedures usually require more medical materials. Moreover, with the extensive replacement of old materials with newer and more sophisticated medical materials, the corresponding medical material costs are rising (5). Therefore, we can draw a conclusion that improving doctors' awareness of the cost of medical consumables, reducing the intermediate links of material circulation, strengthening price control, and increasing clinical rational use of consumables are important ways for medical institutions to reduce treatment costs.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Liu¹,

Yu²,

Wang³

et al. 2020

J Thorac Dis

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Background: Esophageal cancer represents a major health threat in China. Esophagectomy is the standard treatment for respectable esophageal cancer. This study aimed to investigate the costs of hospitalization in esophageal cancer patients undergoing esophagectomy, and to analyze the factors influencing these costs.Methods: A retrospective observational study which enrolled 196 patients who underwent esophagectomy from September, 2018, to April, 2019, in the Affiliated Cancer Hospital of Zhengzhou University were conducted Results: The median inpatient cost was ￥72,772 (range, ￥49,796-128,771). Materials accounted for 39.7% of the direct medical costs, which was the highest proportion for any of the cost components. Minimally invasive esophagectomy (MIE, OR: 0.031; 95% CI: 0.005-0.209), cardiopathy comorbidity (OR: 0.344; 95% CI: 0.136-0.872), and anastomotic leak (OR: 0.012; 95% CI: 0.001-0.131) were risk factors for higher cost, while early oral feeding (OR: 3.979; 95% CI: 1.430-11.067) was a protective factor.Conclusions: Understanding the factors associated with high hospitalization costs will help to reduce healthcare expenditure. By controlling complications and promoting early oral feeding, the economic burden on esophagectomy patients can be relieved. Further research based on a longitudinal design is needed to investigate the full costs of hospitalization associated with esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Liu¹,

Yu²,

Wang³

et al. 2020

J Thorac Dis

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“…There were some reports on patients with cancer in China. [30][31][32][33] However, real-world trends in antineoplastic drug use in Chinese patients with CRC have not been fully assessed yet. Besides, the significant price reduction and inclusion of three classic CRC-targeted drugs (cetuximab, bevacizumab and regorafenib) in national health insurance following national negotiations might significantly affect the use of these drugs in patients with CRC.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis

Yao

et al. 2021

BMJ Open

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ObjectivesIt is unclear what is driving rising colorectal cancer (CRC) treatment costs in China, whether an adjustment in drug prices changes use and total cost. This study aims to estimate trends in drug use, prescribing patterns and spending for antineoplastic drug therapies for CRC in major cities of China.MethodsInformation from 128 811 antineoplastic drug prescriptions in CRC was retrospectively collected from the Hospital Prescription Analysis Cooperative Project. The prescriptions extracted included demographic information of patients, the generic name and the price of antineoplastic drugs. The Mann-Kendall and Cochran-Armitage trend test was used to estimate the trends of antineoplastic agent usage.ResultsThe number of antineoplastic prescriptions ranged from 18 966 in 2015 to 34 219 in 2019. Among the prescriptions collected in this study, the annual cost of antineoplastic drugs increased by 117.2%, and average prescription cost increased by 20%. Throughout the study period, the most prescribed antineoplastic drugs were capecitabine, oxaliplatin, fluorouracil and irinotecan, representing 49%, 27%, 21% and 9% of (per cent of visits (PV)). The PV of bevacizumab and cetuximab increased by 494% and 338% (from 1.8% and 1.3% in 2015 to 10.7% and 5.7% in 2019). In prescribing patterns of antineoplastic agents, monotherapy gradually decreased, while combination therapy, especially three-drug combination, increased significantly from 1.35% to 7.31%.ConclusionThis study estimated recent trends of antineoplastic drug use and expenditure for Chinese patients with CRC. These results would inform CRC treatment decisions, including health insurance negotiation, precision therapy access, allocation of research funding and evaluation of the financial burden of CRC drug treatment.

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“…Using coloanal anastomosis techniques such as LAR can have complications of dehiscence and pelvic abscess which can be life threatening and even in moderate cases, can substantially increase the duration of stay and cost [ 4 ]. One large study in Beijing, China found that LAR inpatients median cost was estimated to be around ￥89 064 [ 5 ] (which is around 13 758.25 USD).…”

Section: Introductionmentioning

confidence: 99%

Is pull-through an acceptable replacement for low anterior resection for rectal cancers in low-income setting? A case-control study

Kakaje

Ghareeb

Alahmar

2021

Annals of Medicine &Amp; Surgery

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Background Colorectal cancers are the second most common cancers overall and are the third deadliest cancers. Complete resection is the treatment of choice for rectal cancers and chemoradiotherapy (CRT) is strongly recommended in stage 2 and 3. Low anterior resection (LAR) is the most common procedure used, but it requires the use of stapler which might be very expensive as one study estimated the median cost of LAR inpatients to be over 13.000 USD. However, coloanal pull-through (PT) used to be the common procedure before introducing staplers in the twentieth century and can be less expensive, but with higher complication rates. Materials and methods This is a retrospective case-control study from patients’ records who underwent either LAR or PT for their rectal cancer in Syria. All patients had either stage 2 or 3 cancer and were treated by the same group of surgeons and received the same adjuvant and neoadjuvant CRT protocol. Patients from both groups had the same prognosis and stages. Results This study included 60 participants, of which, 30 had LAR and 30 had PT. They all had successful removal of the cancer and follow-ups were for 1 year after the surgery. There were no significant differences between the two procedures in post-operative leak, urinary retention, stricture, sexual function and recurrence (p > 0.05). However, post-operative incontinence was more frequent with PT (p = 0.027). Conclusion PT can be an acceptable substitute of LAR in low income settings despite having higher incidence of incontinence.

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Direct inpatient costs and influencing factors for patients with rectal cancer with low anterior resection: a retrospective observational study at a three-tertiary hospital in Beijing, China

Cited by 4 publications

References 39 publications

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Factors associated with the costs of hospitalization after esophagectomy: a retrospective observational study at a three-tertiary cancer hospital in China

Antineoplastic prescription among patients with colorectal cancer in eight major cities of China, 2015–2019: an observational retrospective database analysis

Is pull-through an acceptable replacement for low anterior resection for rectal cancers in low-income setting? A case-control study

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