Capita Health Care Expenditure Research Articles

Health care expenditure, economic growth, and population ageing in Japan: empirical evidence using the nonlinear ARDL approach

ABSTRACT In Japan, health care expenditure (HCE) has increased with the rapid ageing of the population. It raises concerns on how the public health care insurance system should be sustained in the future, since the dependence on public burdens is growing under the government’s difficult financial conditions. This study investigates the cointegration relationship between HCE, GDP, and the population ageing rate (AGE) in Japan for the period 1960–2019 by using the nonlinear ARDL approach. The results revealed that per capita HCE may increase more significantly during an economic downturn than during an economic improvement in the long-run. Moreover, an increase in AGE has a positive effect on per capita HCE. These findings show the need to achieve stable economic growth and seriously address the issue of ageing for policymakers in Japan.

Health care expenditure, economic growth, and population ageing in Japan: empirical evidence using the nonlinear ARDL approach

ABSTRACT In Japan, health care expenditure (HCE) has increased with the rapid ageing of the population. It raises concerns on how the public health care insurance system should be sustained in the future, since the dependence on public burdens is growing under the government’s difficult financial conditions. This study investigates the cointegration relationship between HCE, GDP, and the population ageing rate (AGE) in Japan for the period 1960–2019 by using the nonlinear ARDL approach. The results revealed that per capita HCE may increase more significantly during an economic downturn than during an economic improvement in the long-run. Moreover, an increase in AGE has a positive effect on per capita HCE. These findings show the need to achieve stable economic growth and seriously address the issue of ageing for policymakers in Japan.

The Greek economic crisis and its impact on the national health system

Abstract The Greek economic crisis produced severe economic and social outcomes. A massive rescue package was conditional on implementing a Memorandum of Economic and Financial Policies agreed upon between the Greek government and the EU, European Central Bank, and the International Monetary Fund. The extremely austere fiscal consolidation and the structural reforms accompanying the Greek Economic Adjustment Programmes reduced the country’s GDP. Implementing the austerity policies on the Greek National Health System, which was already facing structural problems, reduced the quality and availability of public health care services. This paper investigates the impact of the GDP change on public healthcare expenditures (HCE) from 2000 to 2018. The empirical analysis reveals a statistically significant positive correlation between the GDP per capita and public healthcare expenditure (HCE) from 2000 to 2014 while the effect of GDP on HCE after the 2015 remains unchanged. This paper contributes to the field’s literature since it determines the impact of GDP on public HCE, specifically matched with empirical results to derive conclusive answers.

Economic impact of inflammatory bowel disease in Catalonia: a population-based analysis.

Inflammatory bowel disease (IBD) has a major economic impact on healthcare costs. The aim of this study was to evaluate the current healthcare expenditure associated with IBD in a population-wide study in Catalonia. Retrospective observational study. All patients with IBD included in the Catalan Health Surveillance System (CHSS) were considered eligible. The CHSS compiles data on more than 7 million individuals in 2020 (34,823 with IBD). Data on the use of healthcare resources and its economic impact were extracted applying the International Classification of Diseases, 10th revision, Clinical Modification codes (ICD-10-CM codes). Health expenditure, comorbidities, and hospitalization were calculated according to the standard costs of each service provided by the Department of Health of the Catalan government. The data on the IBD population were compared with non-IBD population adjusted for age, sex, and income level. IBD costs were recorded separately for Crohn's disease (CD) and ulcerative colitis (UC). Prevalence of comorbidities was higher in patients with IBD than in those without. The risk of hospitalization was twice as high in the IBD population. The overall healthcare expenditure on IBD patients amounted to 164M€. The pharmacy cost represents the 60%. The average annual per capita expenditure on IBD patients was more than 3.4-fold higher (IBD 4200€, non-IBD 1200€). Average costs of UC were 3400€ and 5700€ for CD. The risk of comorbidities was twice as high in patients with IBD and their use of healthcare resources was also higher than that of their non-IBD counterparts. Per capita healthcare expenditure was approximately 3.4 times higher in the population with IBD. The study was not previously registered.

Health care financing and productivity of health care in OECD countries: a stochastic frontier analysis

The effects of health-care expenditure on health outcomes and the efficiency of health-care financing schemes in the OECD are estimated with a panel of 30 countries over 1995–2019. The survival rate constructed from the data on age-standardized health-related mortality is used as the health outcome variable. The stochastic frontier model used in the study accommodates nonmonotonic relationships between the factors of interest and the outcome, allowing us to find the optimal levels of the factors. The marginal effect of per capita health-care expenditure on the maximum achievable survival rate diminishes as the level of spending increases and is no longer statistically positive after health-care spending reaches $4811 (2015 PPP). The optimal share of compulsory financing in health expenditure is between 55 and 65%, and health care systems where it exceeds 90% are significantly less efficient. Health-care systems where the percentage of private financing in health expenditure is below 18% are significantly less efficient than those where it is close to the optimal level of about 62%. Further research is needed to examine the effects on health-care efficiency of more specific characteristics of health-care systems taking into account their complex interactions.

Determinants of life expectancy at birth: a longitudinal study on OECD countries

This paper analyses the influence of several determinants on life expectancy at birth in 36 OECD countries over the 1999–2018 period. We utilized a cross-country fixed-effects multiple regression analysis with year and country dummies and used dynamic models, backward stepwise selection, and Arellano–Bond estimators to treat potential endogeneity issues. The results show the influence of per capita health-care expenditure, incidence of out-of-pocket expenditure, physician density, hospital bed density, social spending, GDP level, participation ratio to labour, prevalence of chronic respiratory diseases, temperature, and total size of the population on life expectancy at birth. In line with previous studies, this analysis confirms the relevance of both health care expenditure and health care system (physicians and hospital beds in our analysis) in influencing a country’s population life expectancy. It also outlines the importance of other factors related to population behaviour and social spending jointly considered on this outcome. Policy makers should carefully consider these mutual influences when allocating public funds, particularly after the COVID-19 pandemic period.

Interregional variability in the use of cardiovascular technologies (2011-2019). Correlation with economic indicators, admissions, and in-hospital mortality

Introduction and objectivesEqual opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality. MethodsThe activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality. ResultsWe identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term. ConclusionsThe results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies, which is not explained by economic differences or by hospital attendance rates due to the corresponding diseases.

The health-adjusted dependency ratio as a new global measure of the burden of ageing: a population-based study

The old-age dependency ratio (OADR), which is the ratio of older people (aged ≥65 years) to working age people (aged 20-64 years), is the most common way to assess and compare the burden of population ageing in different countries. However, the relationship between chronological age and dependency varies widely across countries. We therefore present the health-adjusted dependency ratio (HADR), a new measure of ageing burden based on the ageing-related health of the adult population. In this population-based study we used health data for diseases and injuries for 2017 from the Global Burden of Disease project and population data for 2017 from the UN's Population Division to identify the number of adults (aged >20 years) in each country who have the same or higher ageing-related disease burden as the global average 65-year-old. We then calculated the HADR as the ratio of adults who were less healthy than the average 65-year-old (dependent population) to those in better health (supporting population) and compared the HADR with the OADR for 188 countries. We also used cross-sectional, bivariate regression analysis to investigate whether the HADR is a more powerful predictor of changes in per capita health-care expenditure than the OADR as a measure of predictive validity. Many demographically younger populations have an earlier onset of ageing-related disease, and many demographically older populations have a later onset. For instance, Pakistan has an OADR of 0·09 and an HADR of 0·19, and France has an OADR of 0·35 and an HADR of 0·13. Relative to the OADR, the HADR suggests that Asia, western Europe, and North America have a lower ageing burden, whereas central Asia, southern Asia, and Africa have a greater burden. While Japan and countries in western Europe have the highest OADR, Russia, Papua New Guinea, and countries in southeast Europe have the highest HADR. Relative to the OADR, the HADR suggests that there is much less variation in the burden of ageing across countries than has previously been assumed. HADR was also more closely associated with growth in health spending than the OADR. A 0·1 increase in the HADR was associated with a 2·9 percentage points larger growth rate in per capita spending (p=0·0001), and a 0·1-point increase in the OADR was associated with a 1·8 percentage point larger growth rate. The OADR probably overestimates the burden of population ageing in many demographically older countries and underestimates the ageing burden in many demographically younger countries, which implies that the challenges associated with ageing are more universal than previously thought, and that the world cannot easily be divided in a young and an old groups of nations. None.

Variabilidad interregional en el uso de tecnologías cardiovasculares (2011-2019). Correlación con índices económicos y frecuentación y mortalidad hospitalarias

Introduction and objectivesEqual opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality. MethodsThe activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality. ResultsWe identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term. ConclusionsThe results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies, which is not explained by economic differences or by hospital attendance rates due to the corresponding diseases.

Health Care Expenditures Among Individuals With Chronic Psychotic Disorders in Ontario: An Analysis Over Time.

Chronic psychotic disorders are severe and disabling mental disorders associated with poor psychiatric and medical outcomes, and among the most costly mental disorders to treat. Understanding trends in aggregate health care expenditures over time, and respective drivers, can provide relevant insights for decision makers, namely around appropriate allocation of scarce resources within the health care sector. Using administrative health care times series data from Ontario, this analysis examined trends in aggregate public health care expenditures and activity from 2012 to 2019 among all individuals with a diagnosis of a chronic psychotic disorder. Total aggregate health care expenditures for individuals with a chronic psychotic disorder in Ontario increased at a moderate rate over this time period, in line with the growth of the number of people diagnosed, and thus not likely driven by unit costs or resource use. Psychiatric hospitalizations made up the largest share of health care expenditures (~30%). Nonetheless, among all health services, expenditures of acute medical hospitalizations, outpatient prescription drugs and home care saw the largest growth over time. Mean/per capita health care expenditures were greater for females, and increased with age as well as with the presence of comorbidities/chronic conditions. In particular, mean/per capita health care expenditures increased steadily with the number of comorbidities and were highest for individuals with 5 or more comorbidities and those with congestive heart failure, highlighting the ever-increasing importance of addressing physical health conditions among this patient population. These findings will have important implications for decision makers, namely around the appropriate allocation of health care resources for patients with chronic psychotic disorders. Future research should continue to monitor health care expenditures for individuals with chronic psychotic disorders as well as extend this analysis beyond 2019 to understand how the COVID-19 pandemic, and resulting lockdowns, has impacted aggregate health care expenditures and outcomes for patients living with chronic psychotic disorders.

Establishing the relationship between population aging and health care expenditure in India

Purpose The main purpose of this paper is to examine the role of population aging in determining the health care expenditure (HCE) in India over the period 1981 to 2018. Design/methodology/approach While establishing the linkage between population aging and HCE, the study has used economic growth, urbanization and CO2 emissions as control variables and used the autoregressive distributed lag (ARDL) approach to cointegration and VECM based Granger causality approach to estimate both the long-run and short-run relationships among the variables. Findings The results of the ARDL bounds test showed that there is a stable and long-run relationship among the variables. The long-run and short-run coefficients reveal that population aging and income per capita exert a statistically significant and positive effect on per capita HCE in India. The VECM causality evidence shows that there is a presence of short-run causality from economic growth and population aging to per capita HCE, urbanization to environmental degradation and further from aging to urbanization. However, the long-run causality evidence confirms unidirectional causality from population aging to the per capita HCE. Research limitations/implications The research findings could be improved by considering the changes in mortality rate over time because of other environmental factors such as air pollution, among others as control variables. Various other variables affecting the health of an aged person could be considered for better research outcome which is not included in the present study because of the paucity of data. However, the present research findings would certainly serve effective policy instrument aiming at maximizing health gains that are highly associated with the elderly population and economic growth towards achieving sustainable development in India. Originality/value The uniqueness of the present study lies in its estimation where the relationship between population aging and HCE is looked at while considering the impact of other environmental factors separately. The causal relationship is shown among the variables using updated econometrics time-series techniques. The study tried to resolve the ambiguity associated with the relationship between aging and HCE at a macro level.

The health capital and efficiency of regional health care systems: The conformances and contradictions

The article explores relationship between health capital and efficiency indices of regional health systems. The correlation analysis of relationship between individual subjective assessments of health capital and objective indices of health care system functioning in the regions and the Federal Okrugs of the Russian Federation based on application of Minmax technology was carried out. The determination of level of health capital was implemented according to results of population survey and subsequent modeling. The effectiveness of regional health care systems was assessed using indices of healthy life expectancy, percentage of the disabled and per capita health care expenditures in the regions. It is established that 1/3 of subjects of the Russian Federation have high level of health care efficiency. However, the high level of health capital was noted in 12.5% of subjects, while in 40% of them its level was low. There are pronounced regional differences in the stock of health capital. The highest level of health capital was established in the subjects of the North Caucasian Federal Okrug that is conditioned by higher healthy life expectancy and higher efficiency of health care system at lower per capita costs. The statistically significant differences between subjective and objective factors affecting assessment of health capital are presented. The lower per capita health care costs and high percentage of the disabled have no significant impact on health capital of the population in the regions of Russia. The differences between health capital and regional health system performance indices are conditioned by subjective nature of health capital estimates that are determined by individuals within social groups and are characterized by persistent systematic differences between regions.

The spillover effect of fiscal environmental protection spending on residents' medical and healthcare expenditure: evidence from China.

The Chinese government has not only been increasing investments in environmental protection, improving the quality of the ecological environment, but has also been focusing on curbing the excessive growth of medical and healthcare expenses so as to ease the economic burden of China's residents. Both aspects are significant concerns worldwide and have received much research attention individually, but the relationship between government environmental protection expenditure and residents' medical and healthcare expenditure remains unclear. Based on panel data from 31 provinces in China from 2007 to 2019, this paper empirically reveals that fiscal environmental protection expenditure is significantly negatively correlated with per capita medical and healthcare expenditure of residents (including outpatient expenditure and inpatient expenditure). This study shows that increasing the fiscal environmental protection expenditure can help curb the rising level of residents' medical and healthcare expenditure. In addition, the results of heterogeneity analysis indicate that the above relationship is stronger in provinces with a relatively low level of economic development or low proportion of the population over 65years old. Management implications are discussed.

Dialysis and Total Health Care Costs in the United States and Worldwide: The Financial Impact of a Single-Payer Dominant System in the US.

Significance Statement In the United States, dialysis provision is an example of a robust, single-payer dominant system with cost containment. When compared with the cost of dialysis in other countries, Medicare dialysis costs in the United States as a function of overall health care expenditures are approximately $60,000 per patient less than expected, likely due to substantial cost containment imposed by Medicare as the dominant payer.

Antidepressant treatment effects and country income: meta-regression analysis of individual participant data from duloxetine trials.

In recent decades, significant numbers of pharmaceutical trials have gradually been relocated to low- and middle-income countries. However, there is little evidence regarding the transferability of trial outcomes across countries. Analysing duloxetine randomised controlled trials (RCTs) conducted in different countries, we investigated whether per capita gross national income (GNI) and healthcare expenditure (HE) are associated with pre-post mean changes of depression severity and differences in duloxetine-placebo effect sizes. Meta-analyses included RCTs investigating duloxetine efficacy in patients with depression. Individual participant data (IPD) from multi-centre duloxetine trials were provided by the manufacturer. Data extracted from published reports also entered analyses in case of trials conducted in only one country. A meta-regression approach was applied to analyse associations of GNI and HE with standardised pre-post mean change using raw score standardisation (SMCR) and comparative effect size, that is, the mean differences (MD) in pre-post effect size between duloxetine and placebo treatment. 23 trials with 8417 randomised participants entered analyses. Regression coefficients indicated a negative linear relationship of SMCR with GNI (z-standardised β=-3.61, R2 =14.8%, p < 0.001) and HE (β=-4.72, R2 =24.8%, p < 0.001) for participants treated with duloxetine. Similar associations were found for placebo treatment (GNI: β=-3.52, R2 =23.8%, p < 0.001; β=-3.34, R2 =21.0% p < 0.001). Neither GNI nor HE was associated with the MD between duloxetine and placebo pre-post differences. Findings challenge the idea of the universal transferability of antidepressant trial outcomes across countries. Understanding the results of antidepressant RCTs demands more sophisticated clarification of context factors involved in determining effectiveness of antidepressant medication and should be discussed with a view to socio-economic context in their countries of origin.

Clan Mutual Assistance and Commercial Health Insurance Demand

The outbreak of “2019-nCoV” rings the alarm bell of illness risks. Recently, according to “China Statistical Yearbook”, the annual growth rate of per capita health care expenditure in China has recorded double-digit since 2014, which is creating huge medical expenditure burdens and hardly ignored in residents’ daily life. When pursuing a better life, the difficulties and high costs of getting medical services have threaten residents’ normal living for a long time. “2019 Medical Trends around the World” issued by Marsh & McLennan Companies indicated that the inflation rate of medical expenditure was up to 9.7% in China 2018, which means falling into or falling back to poverty for catching diseases would still bother residents’ mind. How to choose an appropriate way of illness risk transfer is an unavoidable problem for residents.Clan mutual assistance has been a traditional way to share the loss of diseases since ancient times, whereas commercial health insurance is a more efficient way in modern market for healthy risk sharing. As a result, clan mutual assistance will influence commercial health insurance demand. However, previous literature only pays attention on the “crowd-out” relationship between clan mutual assistance and commercial health insurance. Those researches ignore that folks can use both clan mutual assistance and commercial health insurance to improve health care levels. Besides, illness risk information can be delivered by clan mutual assistance, which will stimulate clan members’ risk perception and improve their commercial health insurance demand.Based on China Household Finance Survey Data（CHFS）, this paper sets variables from culture and transfer expenditure perspectives to show that clan mutual assistance can “crowd in” commercial health insurance demand, which is still robust when considering the endogenous effect. In mechanism analysis, by using semiparametric difference-in-difference（SDID）, clan mutual assistance impacts commercial health insurance demand by delivering illness risk perception. Besides, the moderating effect indicates that when receiving illness risk information from clan mutual assistance, people who have higher finance literacy in low income group will have more tendencies to buy commercial health insurance. Heterogeneity analyses find that urban group enjoying higher quality social welfare has more “crowd-in” effect than rural group; in the majority of age ranges, clan mutual assistance shows a positive effect on folks’ commercial health insurance demand.Therefore, when marketing the commercial health insurance, insurance industry should avoid putting clan mutual assistance and commercial health insurance into two opposite poles, so as to reduce residents’ resistance to commercial health insurance. Secondly, insurance industry needs to expand the rural market to give more connections between rural residents and commercial health insurance, which will improve commercial health insurance demand in rural areas. Thirdly, suburb can be a crucial segmental market where insurance industry can explain the limits of clan mutual assistance and persuade new citizens migrating from rural places to use commercial health insurance to share illness risks.

Healthcare Financing and Under-5 Child Mortality Among the BRICS Nations

This article explores longitudinal trends of healthcare financing and mortality levels among the children under 5 (U5) years of age in the BRICS nations between 2000 and 2015. This analysis is based on the relevant secondary data obtained from the WHO data repository and various other publicly available sources. Inferential statistical tools like linear regression analysis was carried out to test the relationship between dependent and independent variables. The results indicate an inverse relationship between current health expenditure and U5 child deaths, revealing a decline of 29,000 U5 child deaths and 19,000 infant deaths for every US$1increase in per capita healthcare expenditure. Further, neonatal deaths declined by 1.74% and infant deaths 2.8%, while U5 child deaths declined by 4.6% per annum. India spends lowest among the BRICS nations—about US$63 per capita, while out-of-pocket expenditure (OOPE) is highest at 69.3%. Countries with higher per capita government health expenditure have better health indicators. This article, therefore, calls for strengthening public investment in healthcare to improve health outcomes.

Health care expenditure and health outcomes in sub‐Saharan African countries

AbstractThis paper studies the effect of health care expenditure on health outcomes in sub‐Saharan Africa (SSA) using data from 1995 to 2018 for 45 countries. It uses fixed effects and generalized methods of moments estimation approaches for the analysis. The paper measures health care expenditure using three proxies: namely, total health care expenditure per capita, public health care expenditure to gross domestic product (GDP), and private health care expenditure to total health expenditure. Health outcomes are measured by child health outcomes (under‐5 mortality rate) and life expectancy. The results show that increase in health care expenditure as measured by total health care expenditure per capita and public health care expenditure to GDP leads to decline in under‐5 mortality rates. The results also show that total health care expenditure per capita leads to an increase in life expectancy. The study therefore recommends that governments in SSA increase budget allocations towards the health care sector to achieve better health outcomes.

Drinking water quality impacts on health care expenditures in the United States

Abstract This research explores the relationship between episodes of contaminated drinking water and health care expenditures in the United States. The analysis relies on panel data from the 48 contiguous states from 2000 to 2011. We use the population served by public water systems that violate health-based standards of the Safe Drinking Water Act as a proxy for contaminated drinking water. We estimate spatial and non-spatial models and control for factors that may affect per capita health care expenditures including variables that reflect air quality violations along with ability to pay plus demand for and supply of health care services. The results from a Spatial Durbin Model indicate that a 1% decrease in the annual percentage of population exposed to drinking water quality violations is associated with reductions in in-state and regional effects equal to 0.005% and 0.035% of per capita health care expenditures, respectively. While relatively small on a per capita basis, drinking water violations have a larger impact on health care expenditures than air quality violations (whose effects are not statistically different from zero). However, compared to other factors, such as Medicare enrollment and income, the impact of these violations on health care expenditures is small. We find that the cumulative regional health care expenditure impacts from drinking water violations are substantially greater than in-state impacts. Thus, a regional approach is recommended to addressing drinking water quality improvements.

The association between the socioeconomic status and systemic comorbidities in patients with oral cancers: a retrospective study in Guangxi Province.

It is unclear whether and how the prevalence of systemic comorbidities in oral cancer patients would change with socioeconomic development. A retrospective study of association between socioeconomy and prevalence of systemic comorbidities in oral cancer patients from 2003 to 2017 was performed in Guangxi Province, a southwestern part of China. According to the Union for International Cancer Control (UICC) classification, 2814 patients with squamous cell carcinoma (SCC) of the lip, oral cavity, and oropharynx and 423 patients with ameloblastoma were collected and assigned to the oral cancer group and control group, respectively. Then, comparisons between the socioeconomy and healthcare expenditure in Guangxi Province, the whole China, and the USA were carried out. The prevalence of systemic comorbidities in oral cancer patients increased from 0.820% in 2003 to 32.302% in 2017, which was significantly higher than that in non-cancer patients(P< 0.001) and was positively correlated with the increase in gross regional product (GRP) (r= 0.911, P< 0.001) and per capita GRP (r= 0.910, P< 0.001) of Guangxi Province. In addition, the prevalence of cardiovascular diseases has the largest correlation coefficient with GRP(r= 0.957, P< 0.001) and per capita GRP(r= 0.959, P< 0.001). And the prevalence of endocrine diseases increased by 13.402% and exhibited the most significant increase in 15years. The per capita health care expenditure of Guangxi Province and whole China was nearly equal (P= 0.353). Although the health care expenditure of Guangxi Province had been increasing year by year, its proportion in GRP remains far below that of the USA. With socioeconomic growth, oral cancer patients in Guangxi Province are more common to comorbid with systemic diseases. Cardiovascular and endocrine diseases may be the most susceptible systemic comorbidities in oral cancer patients to the socioeconomic status. In order to control the prevalence of systemic diseases, the government of Guangxi Province may need to expend more budgets in the health care. Clinicians need to pay more attention to the detection of systemic comorbidities and the concept of multidisciplinary collaboration. Instructing oral cancer patients to treat and control systemic comorbidities is also an indispensable part in the treatment of oral cancer.