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Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study

文献类型：期刊论文

作者Wang, Hong2; Ma, Li3; Gu, Xiao-Fen4; Li, Li5; Wang, Wen-Jun6; Du, Ling-Bin7; Xu, Hui-Fang2; Cao, He-Lu8; Zhang, Xi9; Shi, Ji-Hai10
刊名ANNALS OF TRANSLATIONAL MEDICINE
出版日期2022-03-01
卷号10
ISSN号2305-5839
关键词Colorectal cancer (CRC) medical expenditure China
DOI10.21037/atm-22-1001
通讯作者Zhang, Shao-Kai(shaokaizhang@126.com) ; Qiao, You -Lin(qiaoy@cicams.ac.cn)
英文摘要Background: Colorectal cancer (CRC) causes a substantial disease burden in China. Information on the medical expenditure of CRC patients is critical for decision-makers to allocate medical resources reasonably, however, relevant data is limited in China, especially advanced CRC. The aim of this survey was to quantify the out-of-pocket medical expenditure of advanced CRC and explore associated factors. Methods: A nation-wide, multi-center, cross-sectional survey was conducted from March 2020 to March 2021. Nineteen hospitals in seven geographical regions were selected by multi-stage stratified sampling. For each eligible CRC patient with stage III or IV disease in the selected hospitals, the socio-demographics, clinical information, and range of out-of-pocket medical expenditure data were collected based on patients' self-reporting or medical records. Multivariable logistic analysis was used to explore associated factors of medical expenditure. All statistical analyses were conducted using SAS 9.4. Results: The mean age of the 4,428 advanced CRC patients included was 59.5 +/- 11.6 years, 59.6% were male, and 80.1% of patients were in stage III or IV at the time of diagnosis. Besides, 57.2% of patients had an annual household income of less than 50,000 Chinese Yuan (CNY), 40.9% of patients had an out-ofpocket medical expenditure of 50,000-99,999 CNY. As for the affordability of medical expenditure, 33.2% could afford 50,000-99,999 CNY. Multivariate analysis showed that patients who were in the southern [odds ratio (OR): 1.63, 95% confidence interval (CI): 1.31-2.03] and southwestern (OR: 1.55, 95% CI: 1.25-1.93), were in stage III at the time of diagnosis (OR: 1.33, 95% CI: 1.13-1.57), visited three or more hospitals (OR: 1.26, 95% CI: 1.04-1.52), had sought cross-regional health care (OR: 1.60, 95% CI: 1.40-1.83), used genetic testing (OR: 1.26, 95% CI: 1.10-1.45) and targeted drugs (OR: 2.12, 95% CI: 1.79-2.51) had higher out-ofpocket medical expenditure. Conclusions: Patients with advanced CRC had a high out-of-pocket medical expenditure. It is necessary to strengthen the prevention and control of CRC to reduce the disease burden; also, it is critical to deepen the reform of the medical system, increase proportion of medical insurance reimbursement, and remove barriers to cross-regional health care.
WOS关键词DIAGNOSIS
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:000785814200083
资助机构Beijing Love Book Cancer Foundation ; Merck Serono Co., Ltd.
源URL[http://ir.hfcas.ac.cn:8080/handle/334002/131539]  
专题中国科学院合肥物质科学研究院
通讯作者Zhang, Shao-Kai; Qiao, You -Lin
作者单位1.China Med Univ, Liaoning Canc Hosp & Inst, Liaoning Off Canc Control & Res, Canc Hosp, Shenyang, Peoples R China
2.Zhengzhou Univ, Henan Canc Hosp, Henan Engn Res Ctr Canc Prevent & Control, Dept Canc Epidemiol,Affiliated Canc Hosp,Henan In, Zhengzhou 450008, Peoples R China
3.Dalian Med Univ, Publ Hlth Sch, Dalian, Peoples R China
4.Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Student Affairs, Urumqi, Peoples R China
5.Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China
6.Jining Med Univ, Sch Nursing, Jining, Peoples R China
7.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Dept Canc Prevent, Canc Hosp, Hangzhou, Peoples R China
8.Xinxiang Cent Hosp, Dept Prevent Hlth, Xinxiang, Henan, Peoples R China
9.Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing,Off Canc Prevent & Control, Beijing, Peoples R China
10.Baotou Med Coll, Affiliated Hosp 1, Dept Dermatol, Clin Epidemiol Res Ctr, Baotou, Peoples R China
推荐引用方式
GB/T 7714		 Wang, Hong,Ma, Li,Gu, Xiao-Fen,et al. Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study[J]. ANNALS OF TRANSLATIONAL MEDICINE,2022,10.
APA Wang, Hong.,Ma, Li.,Gu, Xiao-Fen.,Li, Li.,Wang, Wen-Jun.,...&Qiao, You -Lin.(2022).Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study.ANNALS OF TRANSLATIONAL MEDICINE,10.
MLA Wang, Hong,et al."Out-of-pocket medical expenditure and associated factors of advanced colorectal cancer in China: a multi-center cross-sectional study".ANNALS OF TRANSLATIONAL MEDICINE 10(2022).

入库方式： OAI收割

来源：合肥物质科学研究院

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