Abstract
BackgroundIn terms of medical costs, prostate cancer is on the increase as one of the most costly cancers, posing a tremendous economic burden, but evidence on the health care utilization and medical expenditure of prostate cancer has been absent in China.ObjectiveThis study aimed to analyze health care utilization and direct medical costs of patients with prostate cancer in China.MethodsHealth care service data with a national representative sample of basic medical insurance beneficiaries between 2015 and 2017 were obtained from the China Health Insurance Association database. We conducted descriptive and statistical analyses of health care utilization, annual direct medical costs, and composition based on cancer-related medical records. Health care utilization was measured by the number of hospital visits and the length of stay.ResultsA total of 3,936 patients with prostate cancer and 24,686 cancer-related visits between 2015 and 2017 were identified in the database. The number of annual outpatient and inpatient visits per patient differed significantly from 2015 to 2017. There was no obvious change in length of stay and annual direct medical costs from 2015 to 2017. The number of annual visits per patient (outpatient: 3.0 vs. 4.0, P < 0.01; inpatient: 1.5 vs. 2.0, P < 0.001) and the annual medical direct costs per patient (US$2,300.1 vs. US$3,543.3, P < 0.001) of patients covered by the Urban Rural Resident Basic Medical Insurance (URRBMI) were both lower than those of patients covered by the Urban Employee Basic Medical Insurance (UEBMI), and the median out-of-pocket expense of URRBMI was higher than that of UEBMI (US$926.6 vs. US$594.0, P < 0.001). The annual direct medical costs of patients with prostate cancer in Western regions were significantly lower than those of patients in Eastern and Central regions (East: US$4011.9; Central: US$3458.6; West: US$2115.5) (P < 0.001).ConclusionsThere was an imbalanced distribution of health care utilization among regions in China. The direct medical costs of Chinese patients with prostate cancer remained stable, but the gap in health care utilization and medical costs between two different insurance schemes and among regions still needed to be further addressed.
Highlights
Prostate cancer is the second most prevalent cancer in males in the world (Bray et al, 2018; Culp et al, 2020)
This study was based on the China Health Insurance Association (CHIRA) database between 2015– 2017, which contained detailed inpatient and outpatient record information, including patient’s age, sex, diagnoses, medications, and costs of basic medical insurance (BMI) beneficiaries sampled from 82 cities nationwide, representing about 2% of the total population in mainland China (Zhang et al, 2019)
A total of 94.6% of the patients with prostate cancer included in this study were over 60 years old, with an average age of 74.4 years (SD 8.9)
Summary
Prostate cancer is the second most prevalent cancer in males in the world (Bray et al, 2018; Culp et al, 2020). Studies on the economic burden or costs of prostate cancer were mainly focused on the United States, Europe countries (Sanyal et al, 2013; Smith-Palmer et al, 2019), or other developed countries (Grover et al, 1999; Grover et al, 2000; Krahn et al, 2010; Kitazawa et al, 2015; Mervin et al, 2017; Satoh et al, 2018). In terms of medical costs, prostate cancer is on the increase as one of the most costly cancers, posing a tremendous economic burden, but evidence on the health care utilization and medical expenditure of prostate cancer has been absent in China
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