Daily medical expenditures for patients with liver cancer in China from 2002 to 2011: a multicenter retrospective survey_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Yefan ¹ , GUO Lanwei ² , BAI Fangzhou ² , HUANG Zhen ¹ , HUANG Huiyao ² , LIU Chengcheng ² ,  ZHAO Jianjun ¹ ,  SHI Jufang ² ,  DAI Min ² , 城市癌癥早診早治項目衛生經濟學評價工作組

1. Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P.R.China;
2. Office of Cancer Screening, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, P.R.China;

Corresponding?author：

ZHAO Jianjun, Email: zjj8424@sina.com; SHI Jufang, Email: shijf@cicams.ac.cn; DAI Min, Email: daimin2002@hotmail.com

Keywords：

Primary liver cancer; Economic burden; Average daily medical expenditure; Retrospective survey

DOI：

10.7507/1672-2531.201802030

Video：

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ObjectivesTo analyze the average daily medical expenditures for primary liver cancer in China from 2002 to 2011.MethodsThis study employed retrospective survey on multiple centers from 12 provinces and cities in China from 2002 to 2011, based on the continuous data from the Cancer Screening Program in the Urban China Project. The average daily medical expenditures of primary liver cancer patients and influencing factors were analyzed.ResultsA total of 11 045 liver cancer patients from 12 provinces and cities were included, with an average age of 55 and an average duration of hospitalization of 16.76 days. The average daily medical expenditures of liver cancer patients during the 10 years was 1 251 yuan (95%CI 1 236 to 1 266). The average daily medical expenditures was significantly different in regions (1 356 yuan in the east region, 1 209 yuan in the middle region and 1 068 yuan in the west region), types of hospital (1 341 yuan in general hospitals, 1 213 yuan in specialized hospitals) and hospital levels (1 293 yuan in 3A grade hospital, 805 yuan in non-3A grade hospital) (P<0.05). The average daily medical expenditures were 1 253 yuan for stage Ⅰ, 1 169 yuan for stage Ⅱ, 1 167 yuan for stageⅢ and 1 092 yuan for stage Ⅳ (P<0.05). From 2002 to 2011, the average daily medical expenditures of hospitalization increased from 1 079 yuan (95%CI 1 021 to 1 136) to 1 549 yuan (95%CI 1 486 to 1 613), with an average growth rate of 3.69%. Since 2007, a continuous growth was observed. Subgroup analysis suggested there were obvious differences in growth patterns between different regions and hospitals, as well as differences between various treatments.ConclusionsThe average daily medical expenditures of liver cancer in China had been increasing from 2002 to 2011 and there were significant differences between various regions and hospital levels. Combined with data on the change of duration of hospitalization, it can provide reference for the economic evaluation of the nation’s prevention and treatment policies for liver cancer.

Citation： ZHANG Yefan, GUO Lanwei, BAI Fangzhou, HUANG Zhen, HUANG Huiyao, LIU Chengcheng, ZHAO Jianjun, SHI Jufang, DAI Min. Daily medical expenditures for patients with liver cancer in China from 2002 to 2011: a multicenter retrospective survey. Chinese Journal of Evidence-Based Medicine, 2018, 18(5): 434-441. doi: 10.7507/1672-2531.201802030 Copy

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1. IARC. Fact sheets by Population-Globocan-IRAC. Available at: http://globocan.iarc.fr/Pages/fact_sheets_population.aspx.
2. Are C, Meyer B, Stack A, et al. Global trends in the burden of liver cancer. J Surg Oncol, 2017, 115(5): 591-602.
3. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-386.
4. Zheng R, Zeng H, Zhang S, et al. Estimates of cancer incidence and mortality in China, 2013. Chin J Cancer, 2017,36(1): 66.
5. Guo LW, Huang HY, Shi JF, et al. Medical expenditure for esophageal cancer in China: a 10-year multicenter retrospective survey (2002-2011). Chin J Cancer, 2017, 36(1): 73.
6. 陳萬青, 孫可欣, 鄭榮壽, 等. 2014 年中國分地區惡性腫瘤發病和死亡分析. 中國腫瘤, 2018, 27(1): 14.
7. 楊駿, 王樂, 石春雷, 等. 我國 1996–2015 年間肝癌經濟負擔研究系統評價. 中華疾病控制雜志, 2017, 21(8): 6.
8. 苗俊英, 時苗, 王書亞. 病種日均住院費用在控制醫院住院費用中的意義. 中國醫院統計, 2003, 10(3): 2.
9. 陸麗花. 日均住院費用預測及分析. 中國衛生產業, 2012, 9(22): 105.
10. Jinjuvadia R, Salami A, Lenhart A, et al. Hepatocellular carcinoma: a decade of hospitalizations and financial burden in the United States. Am J Med Sci, 2017, 354(4): 362-369.
11. Lee KS, Chang HS, Lee SM, et al. Economic burden of cancer in Korea during 2000-2010. Cancer Res Treat, 2015, 47(3): 387-398.
12. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet, 2018, 391(10127): 1301-1314.
13. Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
14. 肖靜, 高月霞, 陸青云, 等. 6 168 例肝癌患者住院費用影響因素的通徑分析. 中國衛生經濟, 2012, 31(1): 3.
15. 龔紅霞, 劉元強, 馬莉, 等. 蘭州市 1996～2006 年肺癌和肝癌患者住院費用分析. 現代預防醫學, 2012, 39(2): 3.
16. 章娣, 林振平, 張昕, 等. 2006～2013 年某醫院肝癌患者住院費用的影響因素分析. 國外醫學衛生經濟手冊, 2016, 33(3): 4.
17. Yang Z, Zheng R, Zhang S, et al. Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013. Chin J Cancer Res, 2017, 29(5): 385-394.
18. 中國肝移植注冊. 1980–2010 年中國肝移植總體情況. 中華移植雜志(電子版), 2011, 5(4): 3.
19. 蔡秀軍. 腹腔鏡肝切除術的進展. 現代實用醫學, 2013, 25(10): 3.
20. 劉卉, 陳東風. 血管介入治療肝癌栓塞材料臨床進展. 實用肝臟病雜志, 2015, 18(3): 4.
21. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4): 378-390.
22. Zhang S, Wang F, Zhang Z. Current advances in the elimination of hepatitis B in China by 2030. Front Med, 2017, 11(4): 490-501.
23. Kalogeridi MA, Zygogianni A, Kyrgias G, et al. Role of radiotherapy in the management of hepatocellular carcinoma: a systematic review. World J Hepatol, 2015, 7(1): 101-112.

Chinese Journal of Evidence-Based Medicine

Daily medical expenditures for patients with liver cancer in China from 2002 to 2011: a multicenter retrospective survey

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