Direct costs of both inpatient and outpatient care for all type cancers: The evidence from Beijing, China

• Published in: Cancer medicine (Malden, MA) MA), 2019-06, Vol.8 (6), p.3250-3260
• Main Authors: Yin, Xuejun, Xu, Yue, Man, Xiaowei, Liu, Liming, Jiang, Yan, Zhao, Liying, Cheng, Wei
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Age Factors; Aged; Aged, 80 and over; Ambulatory Care - economics; Breast cancer; cancer; Cancer Prevention; Cancer therapies; Child; Child, Preschool; China; China - epidemiology; Colorectal carcinoma; cost analysis; Diagnosis; Disease; Estimates; Fees & charges; Female; Gastric cancer; Generalized linear models; Geography, Medical; Health Care Costs; Health care expenditures; Health Expenditures; Health services; Health services utilization; healthcare utilization; Hospitalization; Hospitalization - economics; Hospitals; Humans; Inpatients; Lung cancer; Male; Medicine; Middle Aged; Neoplasms - epidemiology; Original Research; Outpatients; Patients; Population; Public health; Public Health Surveillance; real world data; Retrospective Studies; Sex Factors; Stomach; Studies; Surgery; Young Adult
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.2184

Background Cancer 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. Methods The 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). Results A 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