Assessment of Medical Expenditure for Patients With Breast Cancer in China: Evidence From Current Curative Expenditure by System of Health Accounts 2011

Ang Zheng; Yalan Zhu; Yuhang Wang; Fang Liu; Feng Jin; Shuang Zang; Xin Wang

doi:10.1016/j.jval.2021.06.015

Assessment of Medical Expenditure for Patients With Breast Cancer in China: Evidence From Current Curative Expenditure by System of Health Accounts 2011

Value Health. 2022 Jan;25(1):77-83. doi: 10.1016/j.jval.2021.06.015. Epub 2021 Aug 31.

Authors

Ang Zheng¹, Yalan Zhu², Yuhang Wang³, Fang Liu⁴, Feng Jin¹, Shuang Zang⁵, Xin Wang⁶

Affiliations

¹ Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
² College of Health Management, China Medical University, Research Center for Health Development - Liaoning New Type Think Tank for University, Shenyang, China.
³ The First Affiliated Hospital of China Medical University, Shenyang, China.
⁴ School of Public Health, China Medical University, Shenyang, China.
⁵ School of Nursing, China Medical University, Shenyang, China.
⁶ College of Health Management, China Medical University, Research Center for Health Development - Liaoning New Type Think Tank for University, Shenyang, China. Electronic address: wxinsmile@qq.com.

PMID: 35031102
DOI: 10.1016/j.jval.2021.06.015

Abstract

Objectives: The incidence and mortality of breast cancer have been increasing in China and bring heavy economic burdens to patients, families, and society. This study aimed to analyze the structure and influencing factors of inpatient expenditures of patients with breast cancer and put forward suggestions for insurance management.

Methods: A multistage stratified random sampling method was used to investigate 379 medical institutions and 7366 pieces of inpatient records of patients with breast cancer in Dalian in 2018. Under the framework of "System of Health Accounts 2011," the current curative expenditure (CCE) and its distribution were calculated. The relationships between hospitalization expenditure and factors were analyzed by multiple stepwise regression and structural equation modeling.

Results: The CCE of patients with breast cancer in Dalian in 2018 was ¥273.38 million, accounting for 10.66% of the total expenditure on cancer. The majority of the CCE flowed to large general hospitals. The CCE was concentrated in patients aged 40 to 69 years (23.46%). The hospitalization expenditure correlated positively with length of stay, surgery, and drug expenses (rs = 0.586-0.754, P < .01) and negatively associated with age (rs = -0.074, P < .01). The length of stay mediated the relationship between surgery and hospitalization expenses for patients with breast cancer. The factors that affected the hospitalization expenditure were the drug expenses, surgery, length of stay, insurance status, and institution level.

Conclusions: The cost control for CCE of breast cancer inpatient treatment is crucial in China. Promoting hierarchical diagnosis and treatment, reducing the length of stay, and improving medical insurance depth would be effective measures to reduce the financial burden of patients.

Keywords: System of Health Accounts 2011; breast cancer; current curative expenditure; hospitalization expenses.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Breast Neoplasms / economics*
Breast Neoplasms / epidemiology
Breast Neoplasms / therapy
China / epidemiology
Cost of Illness*
Female
Health Expenditures / statistics & numerical data*
Humans
Length of Stay / economics*
Middle Aged