No expenditure difference among patients with liver cancer at stage I-IV: Findings from a multicenter cross-sectional study in China

Abstract

Objective The number of liver cancer patients in China accounts for more than half of the world. However, China currently lacks national, multicenter economic burden data, and meanwhile, measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control. Thus, the aim of the study was to measure the economic burden of liver cancer by various subgroups. Methods A hospital-based, multicenter and cross-sectional survey was conducted during 2012-2014, covering 39 hospitals and 21 project sites in 13 provinces across China. The questionnaire covers clinical information, sociology, expenditure, and related variables. All expenditure data were reported in Chinese Yuan (CNY) using 2014 values. Results A total of 2,223 liver cancer patients were enrolled, of whom 59.61% were late-stage cases (III-IV), and 53.8% were hepatocellular carcinoma. The average total expenditure per liver cancer patient was estimated as 53,220 CNY, including 48,612 CNY of medical expenditures (91.3%) and 4,608 CNY of non-medical expenditures (8.7%). The average total expenditures in stage I, II, III and stage IV were 52,817 CNY, 50,877 CNY, 50,678 CNY and 54,089 CNY (P>0.05), respectively. Non-medical expenditures including additional meals, additional nutrition care, transportation, accommodation and hired informal nursing were 1,453 CNY, 839 CNY, 946 CNY, 679 CNY and 200 CNY, respectively. The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY, and 77.2% of the patients suffered an unmanageable financial burden. Multivariate analysis showed that overall expenditure differed in almost all subgroups (P<0.05), except for sex, clinical stage, and pathologic type. Conclusions There was no difference in treatment expenditure for liver cancer patients at different clinical stages, which suggests that maintaining efforts on treatment efficacy improvement is important but not enough. To furtherly reduce the overall economic burden from liver cancer, more effort should be given to primary and secondary prevention strategies.

Staged Nursing Intervention: The Effect of the Compliance in Liver Cancer Patients with Interventional Therapy

“…Currently, the most common first-line treatment strategy is the use of interventional therapy, which could inject the anticancer drugs or embolization agents into the hepatic artery through femoral artery intubation, assisted by angiography, digital subtraction, and other imaging devices, thereby conducting a minimally invasive approach to the local lesions [ 1 ]. Recent developments in interventional therapy have highlighted the merits that it could repeat many times, effectively relieve the symptoms, and prolong the survival period [ 2 – 5 ]; however, the actual therapeutic effect largely depends on the treatment compliance [ 6 ]. In addition, previous research has revealed the poor clinical treatment effect associated with negative emotions.…”

Economic Burden and Quality of Life of Hepatocellular Carcinoma in Greater China: A Systematic Review

“…The quality of the 6 economic burden studies was heterogeneous ( Table 2 ). While 1 study relying on cancer registry claims data was regarded as having “strong” global rating ( 27 ), 2 studies based on hospital databases, social insurance information system, and national health insurance database were rated “moderate” ( 26 , 29 ), and another 3 studies based on survey and hospital electronic health records were rated “weak” ( 25 , 28 , 30 ). A discrepancy occurred and resolved in raters, and the reasons were differences in interpretation of criteria.…”

“…Another hospital-based cross-sectional survey study covering 39 hospitals and 21 project sites in 13 provinces was carried out to investigate the economic burden of liver cancer in mainland China from 2012-2014 ( 28 ). Demographic and societal information, expenditures, and time loss due to clinical visits of 1,196 patients with HCC were investigated with the use of a structured questionnaire.…”

Contemporary trends on expenditure of hospital care on total cancer and its subtypes in China during 2008−2017

“…Meanwhile, advances in treatment including surgical techniques, liver metastasis therapy, and targeted therapy remarkably improved survival rates of patients and prolonged their survival duration, which unavoidably added to the hospitalization expenditure of colorectal cancer currently ( 23 ). Early prevention strategies could help reduce the cancer expenditure in hospitals ( 24 , 25 ).…”