Skip to main content
Top
Published in: BMC Cancer 1/2021

Open Access 01-12-2021 | Lung Cancer | Research

Catastrophic health expenditure and its determinants in households with lung cancer patients in China: a retrospective cohort study

Authors: Cheng-yao Sun, Ju-fang Shi, Wen-qi Fu, Xin Zhang, Guo-xiang Liu, Wan-qing Chen, Jie He

Published in: BMC Cancer | Issue 1/2021

Login to get access

Abstract

Background

Numerous studies have examined catastrophic health expenditures (CHE) worldwide, mostly focusing on general or common chronic populations, rather than particularly vulnerable groups. This study assessed the medical expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China.

Methods

During 2018–2019, a hospital-based multicenter retrospective survey was conducted in seven provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. CHE was measured according to the proportion of out-of-pocket (OOP) health payments of households on non-food expenditures. Chi-square tests and logistic regression analysis was adjusted to determine the factors that significantly influenced the likelihood of a household with lung cancer patient to incur in CHE.

Results

In total, 470 households with lung cancer patients were included in the analysis. Health insurance was shown to protect some households from the impact of CHE. Nonetheless, CHE incidence (78.1%) and intensity (14.02% for average distance and 22.56% for relative distance) were still relatively high among households with lung cancer patients. The incidence was lower in households covered by the Urban Employee Basic Medical Insurance (UEMBI) insurance, with higher income level and shorter disease course.

Conclusion

More attention is needed for CHE incidence among vulnerable populations in China. Households with lung cancer patients were shown to be more likely to develop CHE. Therefore, policy makers should focus on improving the financial protection and reducing the economic burden of this disease.
Literature
3.
go back to reference Xu K, et al. Protecting households from catastrophic health spending. Health Aff. 2007;26(4):972.CrossRef Xu K, et al. Protecting households from catastrophic health spending. Health Aff. 2007;26(4):972.CrossRef
4.
go back to reference Xu K, et al. Assessing the reliability of household expenditure data: results of the world health survey. Health Policy. 2009;91(3):297–305.CrossRef Xu K, et al. Assessing the reliability of household expenditure data: results of the world health survey. Health Policy. 2009;91(3):297–305.CrossRef
7.
go back to reference Liu X, et al. Financial protection of rural health insurance for patients with hypertension and diabetes: repeated cross-sectional surveys in rural China. BMC Health Serv Res. 2016;16(1):481.CrossRef Liu X, et al. Financial protection of rural health insurance for patients with hypertension and diabetes: repeated cross-sectional surveys in rural China. BMC Health Serv Res. 2016;16(1):481.CrossRef
8.
go back to reference Si Y, Zhou Z, Su M, Wang X, Lan X, Wang D, Gong S, Xiao X, Shen C, Ren Y, Zhao D, Hong Z, Bian Y, Chen X. Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves' cross-sectional study. BMJ Open. 2019;9(5):e023033. https://doi.org/10.1136/bmjopen-2018-023033. Si Y, Zhou Z, Su M, Wang X, Lan X, Wang D, Gong S, Xiao X, Shen C, Ren Y, Zhao D, Hong Z, Bian Y, Chen X. Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves' cross-sectional study. BMJ Open. 2019;9(5):e023033. https://​doi.​org/​10.​1136/​bmjopen-2018-023033.
9.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://​doi.​org/​10.​3322/​caac.​21492.
10.
go back to reference Chen W, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res. 2018;030(001):1–12.CrossRef Chen W, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res. 2018;030(001):1–12.CrossRef
14.
go back to reference Dai M, Jufang S, Li N. The design and expected goal for cancer screening program in urban China. Chin J Prev Med. 2013;47(2):179–82 (in Chinese). Dai M, Jufang S, Li N. The design and expected goal for cancer screening program in urban China. Chin J Prev Med. 2013;47(2):179–82 (in Chinese).
15.
go back to reference Ministry of Health of the People ‘s Republic of China. China Health statistics yearbook 2012. Beijing: China Union Medical University Press; 2012. Accessed 20 Mar 2017 (in Chinese) Ministry of Health of the People ‘s Republic of China. China Health statistics yearbook 2012. Beijing: China Union Medical University Press; 2012. Accessed 20 Mar 2017 (in Chinese)
16.
go back to reference Bredenkamp C, Mendola M. Catastrophic and impoverishing effects of health expenditure: new evidence from the Western Balkans. Health Policy Plan. 2011;26(4):349.CrossRef Bredenkamp C, Mendola M. Catastrophic and impoverishing effects of health expenditure: new evidence from the Western Balkans. Health Policy Plan. 2011;26(4):349.CrossRef
17.
go back to reference Galárraga O, et al. Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico. Eur J Health Econ. 2010;11(5):437–47.CrossRef Galárraga O, et al. Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico. Eur J Health Econ. 2010;11(5):437–47.CrossRef
21.
go back to reference Webel K, Greene WH. Econometric analysis. Statal Papers. 2011;52(4):983–4.CrossRef Webel K, Greene WH. Econometric analysis. Statal Papers. 2011;52(4):983–4.CrossRef
22.
go back to reference Hart RA, Clark DH. Does size matter? Exploring the small sample properties of maximum likelihood estimation. In: Annual Meeting of the Midwest Political Science Association; 1999. Hart RA, Clark DH. Does size matter? Exploring the small sample properties of maximum likelihood estimation. In: Annual Meeting of the Midwest Political Science Association; 1999.
23.
go back to reference Eliason SR. Maximum likelihood estimation : logic and practice. J Am Stat Assoc. 1993;89(427):1150. Eliason SR. Maximum likelihood estimation : logic and practice. J Am Stat Assoc. 1993;89(427):1150.
27.
go back to reference Wu QH, et al. Effect of health insurance on reduction of catastrophic health expenditure in China. Chin J Health Policy. 2012;9:62–6. Wu QH, et al. Effect of health insurance on reduction of catastrophic health expenditure in China. Chin J Health Policy. 2012;9:62–6.
28.
go back to reference TAS., G. Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries. BMC Med. 2015;13(1):1–11.CrossRef TAS., G. Catastrophic health expenditure and 12-month mortality associated with cancer in Southeast Asia: results from a longitudinal study in eight countries. BMC Med. 2015;13(1):1–11.CrossRef
29.
go back to reference Wang Z, Li X, Chen M. Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China. Int J Equity Health. 2015;14(1):8.CrossRef Wang Z, Li X, Chen M. Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China. Int J Equity Health. 2015;14(1):8.CrossRef
Metadata
Title
Catastrophic health expenditure and its determinants in households with lung cancer patients in China: a retrospective cohort study
Authors
Cheng-yao Sun
Ju-fang Shi
Wen-qi Fu
Xin Zhang
Guo-xiang Liu
Wan-qing Chen
Jie He
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-021-09030-w

Other articles of this Issue 1/2021

BMC Cancer 1/2021 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