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Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study

文献类型：期刊论文

作者Zhang, Jian-Gong19; Wang, Hong19; Gu, Xiao-Fen18; Wang, Xiao-Yang19; Wang, Wen-Jun17; Du, Ling-Bin16; Cao, He-Lu15; Zhang, Xi14; Shi, Ji-Hai13; Zhao, Yu-Qian12
刊名ANNALS OF TRANSLATIONAL MEDICINE
出版日期2022-03-21
ISSN号2305-5839
关键词Colorectal cancer (CRC) cross-regional healthcare-seeking cross-sectional study
DOI10.21037/atm-22-1003
通讯作者Han, Bin-Bin(wenwxf006@126.com) ; Qiao, You-Lin(qiaoy@cicams.ac.cn)
英文摘要Background: The imbalanced allocation of medical resources leads to the occurrence of cross-regional healthcare-seeking in China. Due to the low cure rate, advanced colorectal cancer (CRC) patients may seek cross-regional healthcare for high-level medical facilities. Investigating status of cross-regional healthcare-seeking and its associated factors among advanced CRC patients is important for policymakers to understand access to health services and improve the quality of oncology services. Methods: From March 2020 to March 2021, a cross-sectional, nation-wide, hospital-based, multi-center survey was conducted. Nineteen hospitals in seven regions were selected by multi-stage stratified sampling.All eligible CRC patients in the selected hospitals were invited to participate in the current study. The outcome variable, cross-regional healthcare-seeking, was defined as seeking health facilities outside the local administration policy of medical insurance. The demographics, clinical information, and medical treatment history of each eligible CRC patient in stage III or IV, were collected through the patients' self-reporting or medical records by trained interviewers. Univariate and multivariate logistic analyses were used to explore the associated factors of cross-regional healthcare-seeking. All statistical analyses were conducted using SAS 9.4. Results: A total of 4,589 individuals with advanced CRC were included. The average age of the patients was 60.1 +/- 11.6 years, and 59.5% were males. About 37.5% of the patients suffered from metastatic CRC at first diagnosis. Approximately 36.5% of the patients had sought cross-regional health care previously, and among them, 31.9% had encountered problems. The most common problems included complicated procedures (95.3%), unreimbursed expenses of outpatient service (71.0%), and reimbursement delay (59.4%). Logistic regression analysis showed that patients who completed undergraduate or above [odds ratio (OR) =1.40, 95% confidence interval (CI): 1.13-1.73], had an annual household income of more than 100,000 Chinse Yuan (CNY) (OR =1.46, 95% CI: 1.21-1.78), and had metastasis at diagnosis (OR =1.33, 95% CI: 1.18-1.51) were more likely to seek cross-regional health care. Conclusions: About one third of advanced CRC patients seek cross-regional health care, and 31.9% had encountered problems. There is a need to simplify procedures of reimbursement, optimize direct settlement system and referral mechanisms in order to improve the equality of health services.
WOS关键词HOSPITAL CHOICE ; BYPASS
资助项目Beijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
WOS研究方向Oncology ; Research & Experimental Medicine
语种英语
出版者AME PUBL CO
WOS记录号WOS:000777846400001
资助机构Beijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
源URL[http://ir.hfcas.ac.cn:8080/handle/334002/128721]  
专题中国科学院合肥物质科学研究院
通讯作者Han, Bin-Bin; Qiao, You-Lin
作者单位1.Dalian Med Univ, Publ Hlth Sch, Dalian, Peoples R China
2.Chinese Acad Med Sci & Peking Union Med Coll, Ctr Global Hlth, Sch Populat Med & Publ Hlth, Beijing 100005, Peoples R China
3.Gansu Prov Canc Hosp, Dept Publ Hlth, Lanzhou, Peoples R China
4.Chengdu Med Coll, Sch Publ Hlth, Chengdu, Peoples R China
5.Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China
6.Chongqing Univ, Chongqing Key Lab Translat Res Canc Metastasis &, Canc Hosp, Chongqing, Peoples R China
7.Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China
8.Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Canc Ctr, Guangzhou, Peoples R China
9.Guangxi Med Univ, Affiliated Hosp 1, Dept Canc Prevent & Control Off, Nanning, Peoples R China
10.Wuzhou Red Cross Hosp, Dept Gastroenterol, Wuzhou, Peoples R China
推荐引用方式
GB/T 7714		 Zhang, Jian-Gong,Wang, Hong,Gu, Xiao-Fen,et al. Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study[J]. ANNALS OF TRANSLATIONAL MEDICINE,2022.
APA Zhang, Jian-Gong.,Wang, Hong.,Gu, Xiao-Fen.,Wang, Xiao-Yang.,Wang, Wen-Jun.,...&Qiao, You-Lin.(2022).Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study.ANNALS OF TRANSLATIONAL MEDICINE.
MLA Zhang, Jian-Gong,et al."Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study".ANNALS OF TRANSLATIONAL MEDICINE (2022).

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来源：合肥物质科学研究院

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