Abstract
BackgroundCancer is a major public health issue worldwide. The cost of cancer care imposes a substantial economic burden on society and patient, but it has not been thoroughly studied in China. This study aimed to describe direct cost and cost elements of all cancer types by different beneficial characteristics.MethodsThe research was a retrospective observational study based on inpatient and outpatient records with a primary diagnosis of cancer from 31 hospitals in 2016. Total cost and cost per time were analyzed by cancer type, sources (prescription medicines, consumables fee for diagnosis and surgery, and other health services), and beneficial characteristics (gender and age).ResultsA total of 30 224 eligible inpatient admissions and 485 391 outpatient visits were identified during the study period. Inpatient care costs account for 58.6% cancer treatment costs. Nearly 70% of the total expenditure is spent on patients aged 50‐79 years. Lung cancer had the highest economic cost (15% of overall cancer costs), followed by breast cancer (12%), and colorectal cancer (10%). Anticancer drug cost accounted a large proportion in both inpatient (37.7%) and outpatient care (64.6%). The average cost per inpatient admission was estimated to be $4590.1 (5621.9), ranging from $1157.7 (1349.8) for testis cancer to $7975 (7343.9) for stomach cancer. The regression analyses revealed that length of hospital stay, cancer type, age, payment type, and hospital level were highly correlated with the expenditure per admission (P < 0.001).ConclusionsThe cancer care cost is substantial and varies with cancer type. Our findings provide important information for health service planning, allowing more efficient allocation of health resources for the care of people with cancer.
Highlights
Cancer is a major public health issue worldwide
As for the expenditure pattern, we found that cost attributed to medication accounted a large proportion in both inpatient (37.7%) and outpatient care (64.6%) across all kinds of cancers
We identified the evidence that lung cancer had the highest economic cost (15% of overall cancer costs), followed by breast cancer (12%) and colorectal cancer (10%), which is consistent with previous studies domestic and aboard.[10,20]
Summary
Cancer is the leading cause of death in China as well as worldwide.[1,2,3] It has become a major public health concern and caused severe economic burdens on society. Economic burden of cancer has been assessed in many countries, such as the United States,[7] the United Kingdom,[8] India,[9] and across the European Union,[10] the current evidence on the cost of cancer treatment in China is limited. Studies on cancer in China mostly focus on the incidence and prevalence of cancer, or treatment cost of specific cancer types such as stomach cancer, esophageal cancer, and liver cancer.[11,12,13] There are few studies providing valuable evidence for the economic burden of all cancer types. Results of the study will provide a detailed baseline, with which to compare future costs and facilitate assessment of the cost‐effectiveness of potential new interventions in cancer control as well as inform an objective public policy framework for the allocation of governmental research funds
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