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

Cheng-Yao Sun,Wen-Qi Fu,Ju-Fang Shi,Guo-Xiang Liu,Jie He,Wan-Qing Chen,Xin Zhang

doi:10.1186/s12885-021-09030-w

Abstract

BackgroundNumerous 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.MethodsDuring 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.ResultsIn 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.ConclusionMore 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.

Highlights

Some of the fundamental roles of a healthcare system are protecting families from disease-related financial catastrophe and achieving health equality [1]
Regarding type of health insurance, most respondents were covered by health insurance policies, with Urban Employee Basic Medical Insurance (UEBMI) accounting for 54.7% and Urban and Rural Resident Basic Medical Insurance (U&RRBMI) for 44%
Our findings showed that the mean medical expenditure of lung cancer patients was $13,173, which is much higher than the gross domestic product (GDP) per capita in China ($7904 in 2015) [24]

Summary

Introduction

Some of the fundamental roles of a healthcare system are protecting families from disease-related financial catastrophe and achieving health equality [1]. A high incidence of catastrophic health expenditures (CHE) means that a given health system is not achieving its goal of financial protection provision. In this context, a retrospective observational study conducted in 133 countries found that, within 5 years (i.e., from 2005 to 2010), CHE rose from 9.7 to 11.7% [2]. A retrospective observational study conducted in 133 countries found that, within 5 years (i.e., from 2005 to 2010), CHE rose from 9.7 to 11.7% [2] Another survey covering 89 countries worldwide showed that 150 million. This study assessed the medi‐ cal expenditure and compensation of lung cancer, and explored the extent and influencing factors of CHE among households with lung cancer patients in China

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