Medical Cost of Cancer Care for Privately Insured Children in Chile.

Florencia Borrescio-Higa,Nieves Valdés

doi:10.3390/ijerph18136746

Florencia Borrescio-Higa, Nieves Valdés

Open Access

https://doi.org/10.3390/ijerph18136746

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Abstract

Medical care for children with cancer is complex and expensive, and represents a large financial burden for families around the world. We estimated the medical cost of cancer care for children under the age of 18, using administrative records of the universe of children with private insurance in Chile in the period 2007–2018, based on a sample of 3853 observations. We analyzed total cost and out-of-pocket spending by patients’ characteristics, type of cancer, and by service. Children with cancer had high annual medical costs, USD 32,287 on average for 2018. Costs were higher for the younger children in the sample. The vast majority of the cost was driven by inpatient hospital care for all types of cancer. The average total cost increased 20% in real terms over the period of study, while out-of-pocket expenses increased almost 29%. Private insurance beneficiaries faced a significant economic burden associated with medical treatment of a child with cancer. Interventions that reduce hospitalizations, as well as systemwide reforms that incorporate maximum out-of-pocket payments and prevent catastrophic expenditures, can contribute to alleviating the financial burden of childhood cancer.

Highlights

We found the total medical cost of cancer care in 2018 was USD 32,287, which was lower than the cost reported in Mexico and similar to the one reported for Korea [4,18]
The need to address the burden of childhood cancer is urgent, and despite vast heterogeneity across countries, one of the main barriers to cancer care is related to the medical cost of care
Governmental actions in many Latin American and other low- and middleincome countries have launched nationwide cancer registries and have improved cancer care of children, many difficulties persist in terms of timely diagnosis, treatment provision, and prevention of abandonment

Summary

Introduction

Res. Public Health 2021, Cancer is the second-leading cause of death for children ages 5 to 15 in Chile [1]. Public Health 2021, Cancer is the second-leading cause of death for children ages 5 to 15 in Chile [1] For this age group, the age-standardized incidence rate for leukemia (the most common type of cancer) is higher in Chile than the average in Latin America, and is higher than the average for other high-income countries (4.9 vs 4.1 and 4.1 per 100,000 persons/year, respectively), whereas the associated mortality rates are lower than in Latin America, but still higher than in high-income countries (1.4 vs 2.1 and 0.61 per 100,000 persons/year, respectively) [2] The age-standardized incidence rate for leukemia (the most common type of cancer) is higher in Chile than the average in Latin America, and is higher than the average for other high-income countries (4.9 vs. 4.1 and 4.1 per 100,000 persons/year, respectively), whereas the associated mortality rates are lower than in Latin America, but still higher than in high-income countries (1.4 vs. 2.1 and 0.61 per 100,000 persons/year, respectively) [2]

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