Skip to main content
Top
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Medical expenses of urban Chinese patients with stomach cancer during 2002–2011: a hospital-based multicenter retrospective study

Authors: Xiao-Jie Sun, Ju-Fang Shi, Lan-Wei Guo, Hui-Yao Huang, Neng-Liang Yao, Ji-Yong Gong, Ya-Wen Sun, Guo-Xiang Liu, A-Yan Mao, Xian-Zhen Liao, Ya-Na Bai, Jian-Song Ren, Xin-Yu Zhu, Jin-Yi Zhou, Ling Mai, Bing-Bing Song, Yu-Qin Liu, Lin Zhu, Ling-Bin Du, Qi Zhou, Xiao-Jing Xing, Pei-An Lou, Xiao-Hua Sun, Xiao Qi, Yuanzheng Wang, Rong Cao, Ying Ren, Li Lan, Kai Zhang, Jie He, Jia-Lin Wang, Min Dai, The listed authors are on behalf of the Health Economic Evaluation Working Group, Cancer Screening Program in Urban China (CanSPUC)

Published in: BMC Cancer | Issue 1/2018

Login to get access

Abstract

Background

In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients’ medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients’ medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends.

Methods

The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002–2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient.

Results

The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses.

Conclusions

The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China.
Appendix
Available only for authorised users
Literature
1.
go back to reference He J, Gu DF, Wu XG, Reynolds K, Duan XF, Yao CH, Wang JL, Chen C, Chen J, Wildman RP, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353(11):1124–34.CrossRefPubMed He J, Gu DF, Wu XG, Reynolds K, Duan XF, Yao CH, Wang JL, Chen C, Chen J, Wildman RP, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353(11):1124–34.CrossRefPubMed
3.
go back to reference Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25(3):479–86.CrossRefPubMed Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25(3):479–86.CrossRefPubMed
4.
go back to reference Kim JY, Lee HS, Kim N, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, et al. Prevalence and clinicopathologic characteristics of gastric cardia cancer in South Korea. Helicobacter. 2012;17(5):358–68.CrossRefPubMed Kim JY, Lee HS, Kim N, Shin CM, Lee SH, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, et al. Prevalence and clinicopathologic characteristics of gastric cardia cancer in South Korea. Helicobacter. 2012;17(5):358–68.CrossRefPubMed
5.
go back to reference Hori M, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the monitoring of Cancer incidence in Japan (MCIJ) project. Jpn J Clin Oncol. 2015;45(9):884–91.CrossRefPubMed Hori M, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H. Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the monitoring of Cancer incidence in Japan (MCIJ) project. Jpn J Clin Oncol. 2015;45(9):884–91.CrossRefPubMed
7.
go back to reference Lin Y, Ueda J, Kikuchi S, Totsuka Y, Wei WQ, Qiao YL, Inoue M. Comparative epidemiology of gastric cancer between Japan and China. World J Gastroenterol. 2011;17(39):4421–8.CrossRefPubMedPubMedCentral Lin Y, Ueda J, Kikuchi S, Totsuka Y, Wei WQ, Qiao YL, Inoue M. Comparative epidemiology of gastric cancer between Japan and China. World J Gastroenterol. 2011;17(39):4421–8.CrossRefPubMedPubMedCentral
8.
go back to reference Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420–9.CrossRefPubMed Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420–9.CrossRefPubMed
9.
go back to reference Haga K, Matsumoto K, Kitazawa T, Seto K, Fujita S, Hasegawa T. Cost of illness of the stomach cancer in Japan - a time trend and future projections. BMC Health Serv Res. 2013;13:283.CrossRefPubMedPubMedCentral Haga K, Matsumoto K, Kitazawa T, Seto K, Fujita S, Hasegawa T. Cost of illness of the stomach cancer in Japan - a time trend and future projections. BMC Health Serv Res. 2013;13:283.CrossRefPubMedPubMedCentral
10.
go back to reference Knopf KB, Smith DB, Doan JF, Munakata J. Estimating the economic burden of gastric cancer in the United States. In: 2011 ASCO annual meeting, vol. 29. Chicago: J Clin Oncol; 2011. p. e16589. Knopf KB, Smith DB, Doan JF, Munakata J. Estimating the economic burden of gastric cancer in the United States. In: 2011 ASCO annual meeting, vol. 29. Chicago: J Clin Oncol; 2011. p. e16589.
11.
go back to reference Shi J, Shi C, Yue X, Huang H, Wang L, Li J, Lou P, Mao A, Dai M. Economic burden of cancer in China during 1996-2014: a systematic review. Chin J Oncol. 2016;38(12):929–41. Shi J, Shi C, Yue X, Huang H, Wang L, Li J, Lou P, Mao A, Dai M. Economic burden of cancer in China during 1996-2014: a systematic review. Chin J Oncol. 2016;38(12):929–41.
12.
go back to reference Li M, Li G, Zhang Y, Wang Y, Suo Y. Hospitalization expense influential factors analysis of patients with gastric carcinoma in the tertiary hospitals of Shanxi province. Chin Med Record. 2015;16(3):57–9. Li M, Li G, Zhang Y, Wang Y, Suo Y. Hospitalization expense influential factors analysis of patients with gastric carcinoma in the tertiary hospitals of Shanxi province. Chin Med Record. 2015;16(3):57–9.
13.
go back to reference Cun X, Feng X, Li S. Analysis of hospitalization expenditures among 3287 gastric carcinoma inpatients in general hospital. Chin J Public Health. 2010;26(6):703–4. Cun X, Feng X, Li S. Analysis of hospitalization expenditures among 3287 gastric carcinoma inpatients in general hospital. Chin J Public Health. 2010;26(6):703–4.
14.
go back to reference Yao F, Shi CL, Liu CC, Wang L, Song SM, Ren JS, Guo CG, Lou PA, Dai M, Zhu L, et al. Economic burden of stomach cancer in China during 1996-2015: a systematic review. Chi J Prevent Med. 2017;51(8):756–62. Yao F, Shi CL, Liu CC, Wang L, Song SM, Ren JS, Guo CG, Lou PA, Dai M, Zhu L, et al. Economic burden of stomach cancer in China during 1996-2015: a systematic review. Chi J Prevent Med. 2017;51(8):756–62.
15.
go back to reference Meng Q, Yang H, Chen W, Sun Q, Liu X. People's Republic of China: health system review. Health Syst Trans. 2015;5(7):1–217. Meng Q, Yang H, Chen W, Sun Q, Liu X. People's Republic of China: health system review. Health Syst Trans. 2015;5(7):1–217.
16.
go back to reference Ministry of Health of China. China's health statistics yearbook 2011. Beijing: Peking Union Medical College Press; 2011. Ministry of Health of China. China's health statistics yearbook 2011. Beijing: Peking Union Medical College Press; 2011.
17.
go back to reference Xu J, Wang WX, Li YB, Zhang JA, Pavlova M, Liu H, Yin P, Lu ZX. Analysis of factors influencing the outpatient workload at Chinese health centres. BMC Health Serv Res. 2010;10:151.CrossRefPubMedPubMedCentral Xu J, Wang WX, Li YB, Zhang JA, Pavlova M, Liu H, Yin P, Lu ZX. Analysis of factors influencing the outpatient workload at Chinese health centres. BMC Health Serv Res. 2010;10:151.CrossRefPubMedPubMedCentral
18.
go back to reference Wang M, Zhang K, Jiang L. Research on impact factors of malignant Tumor's direct economic burden and medical security system. Chin Gen Pract. 2010;13:4115. Wang M, Zhang K, Jiang L. Research on impact factors of malignant Tumor's direct economic burden and medical security system. Chin Gen Pract. 2010;13:4115.
19.
go back to reference Hu G, Mao A, Dong P, Yan X, Qiu W. Discovery approach and economic burden of six kinds of common cancers patients in Beijing. Cancer Res Prevent Treat. 2015;42(2):171–6. Hu G, Mao A, Dong P, Yan X, Qiu W. Discovery approach and economic burden of six kinds of common cancers patients in Beijing. Cancer Res Prevent Treat. 2015;42(2):171–6.
20.
21.
go back to reference Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PE, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol. 2014;15(5):489–538.CrossRefPubMed Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, Liedke PE, Pramesh CS, Badovinac-Crnjevic T, Sheikine Y, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol. 2014;15(5):489–538.CrossRefPubMed
22.
go back to reference Yang L, Cui Y, Guo SF, Brant P, Li B, Hipgrave D. Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme. B World Health Organ. 2013;91(3):184–94.CrossRef Yang L, Cui Y, Guo SF, Brant P, Li B, Hipgrave D. Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme. B World Health Organ. 2013;91(3):184–94.CrossRef
25.
go back to reference Wang W, Zhu M, Guo D, Chen C, Wang D, Pei F, Ma L. Off-label and off-NCCN guidelines uses of antineoplastic drugs in China. Iran J Public Health. 2013;42(5):472–9.PubMedPubMedCentral Wang W, Zhu M, Guo D, Chen C, Wang D, Pei F, Ma L. Off-label and off-NCCN guidelines uses of antineoplastic drugs in China. Iran J Public Health. 2013;42(5):472–9.PubMedPubMedCentral
26.
go back to reference Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China's huge and complex health-care reforms. Lancet. 2012;379(9818):833–42.CrossRefPubMed Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China's huge and complex health-care reforms. Lancet. 2012;379(9818):833–42.CrossRefPubMed
28.
go back to reference Hornbrook MC, Fishman PA, Ritzwoller DP, Elston-Lafata J, O'Keeffe-Rosetti MC, Salloum RG. When does an episode of care for cancer begin? Med Care. 2013;51(4):324–9.CrossRefPubMedPubMedCentral Hornbrook MC, Fishman PA, Ritzwoller DP, Elston-Lafata J, O'Keeffe-Rosetti MC, Salloum RG. When does an episode of care for cancer begin? Med Care. 2013;51(4):324–9.CrossRefPubMedPubMedCentral
29.
go back to reference Yabroff KR, Warren JL, Schrag D, Mariotto A, Meekins A, Topor M, Brown ML. Comparison of approaches for estimating incidence costs of care for colorectal cancer patients. Med Care. 2009;47(7 Suppl 1):S56–63.CrossRefPubMed Yabroff KR, Warren JL, Schrag D, Mariotto A, Meekins A, Topor M, Brown ML. Comparison of approaches for estimating incidence costs of care for colorectal cancer patients. Med Care. 2009;47(7 Suppl 1):S56–63.CrossRefPubMed
30.
go back to reference Manning WG, Basu A, Mullahy J. Generalized modeling approaches to risk adjustment of skewed outcomes data. J Health Econ. 2005;24(3):465–88.CrossRefPubMed Manning WG, Basu A, Mullahy J. Generalized modeling approaches to risk adjustment of skewed outcomes data. J Health Econ. 2005;24(3):465–88.CrossRefPubMed
31.
go back to reference Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed
32.
go back to reference National Bureau of Statistics of China. China statistical yearbook 2012. Beijing: China Statistics Press; 2012. National Bureau of Statistics of China. China statistical yearbook 2012. Beijing: China Statistics Press; 2012.
33.
go back to reference Zaidi AA, Ansari TZ, Khan A. The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital. Int J Equity Health. 2012;11:60.CrossRefPubMedPubMedCentral Zaidi AA, Ansari TZ, Khan A. The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital. Int J Equity Health. 2012;11:60.CrossRefPubMedPubMedCentral
34.
go back to reference Gonzalez-Robledo MC, Wong R, Ornelas HA, Knaul FM. Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios. E Cancer Med Sci. 2015;9:587. Gonzalez-Robledo MC, Wong R, Ornelas HA, Knaul FM. Costs of breast cancer care in Mexico: analysis of two insurance coverage scenarios. E Cancer Med Sci. 2015;9:587.
35.
go back to reference World Bank. World view. In: World development indicators 2011. Washington, DC: World Bank Publications; 2011. p. 11. World Bank. World view. In: World development indicators 2011. Washington, DC: World Bank Publications; 2011. p. 11.
36.
go back to reference Haider MR, Qureshi Z, Salloum R, Heidari K, Xirasagar S, Bennett C, Khan MM. Cancer care costs trend in the United States: findings from the medical expenditure panel survey 2008-2011. Value Health. 2014;17(3):A100.CrossRef Haider MR, Qureshi Z, Salloum R, Heidari K, Xirasagar S, Bennett C, Khan MM. Cancer care costs trend in the United States: findings from the medical expenditure panel survey 2008-2011. Value Health. 2014;17(3):A100.CrossRef
37.
go back to reference World Bank. World view. In: World development indicators 2013. Washington, DC: World Bank Publications; 2013. p. 24. World Bank. World view. In: World development indicators 2013. Washington, DC: World Bank Publications; 2013. p. 24.
38.
go back to reference Chen W, Zheng R, Zuo T, Zeng H, Zhang S, He J. National cancer incidence and mortality in China. Chin J Cancer Res. 2012;28(1):1–11. Chen W, Zheng R, Zuo T, Zeng H, Zhang S, He J. National cancer incidence and mortality in China. Chin J Cancer Res. 2012;28(1):1–11.
39.
go back to reference Day K, Alfonzo M, Chen Y, Guo Z, Lee KK. Overweight, obesity, and inactivity and urban design in rapidly growing Chinese cities. Health Place. 2013;21:29–38.CrossRefPubMed Day K, Alfonzo M, Chen Y, Guo Z, Lee KK. Overweight, obesity, and inactivity and urban design in rapidly growing Chinese cities. Health Place. 2013;21:29–38.CrossRefPubMed
41.
go back to reference Yuan W, Yang N, Li X. Advances in understanding how heavy metal pollution triggers gastric Cancer. Biomed Res Int. 2016;2016:7825432.PubMedPubMedCentral Yuan W, Yang N, Li X. Advances in understanding how heavy metal pollution triggers gastric Cancer. Biomed Res Int. 2016;2016:7825432.PubMedPubMedCentral
44.
go back to reference Huang H-Y, Shi J-F, Guo L-W, Zhu X-Y, Wang L, Liao X-Z, Liu G-X, Bai Y-N, Mao AY, Ren J-S, et al. Expenditure and financial burden for common cancers in China: a hospital-based multicentre cross-sectional study. Lancet. 2016;388(Special Issue):S10.CrossRef Huang H-Y, Shi J-F, Guo L-W, Zhu X-Y, Wang L, Liao X-Z, Liu G-X, Bai Y-N, Mao AY, Ren J-S, et al. Expenditure and financial burden for common cancers in China: a hospital-based multicentre cross-sectional study. Lancet. 2016;388(Special Issue):S10.CrossRef
Metadata
Title
Medical expenses of urban Chinese patients with stomach cancer during 2002–2011: a hospital-based multicenter retrospective study
Authors
Xiao-Jie Sun
Ju-Fang Shi
Lan-Wei Guo
Hui-Yao Huang
Neng-Liang Yao
Ji-Yong Gong
Ya-Wen Sun
Guo-Xiang Liu
A-Yan Mao
Xian-Zhen Liao
Ya-Na Bai
Jian-Song Ren
Xin-Yu Zhu
Jin-Yi Zhou
Ling Mai
Bing-Bing Song
Yu-Qin Liu
Lin Zhu
Ling-Bin Du
Qi Zhou
Xiao-Jing Xing
Pei-An Lou
Xiao-Hua Sun
Xiao Qi
Yuanzheng Wang
Rong Cao
Ying Ren
Li Lan
Kai Zhang
Jie He
Jia-Lin Wang
Min Dai
The listed authors are on behalf of the Health Economic Evaluation Working Group, Cancer Screening Program in Urban China (CanSPUC)
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4357-y

Other articles of this Issue 1/2018

BMC Cancer 1/2018 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine