Health insurance and inequalities in catastrophic health spending in cancer patients. A cross-sectional study in China

IF 1.5 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Gaceta Sanitaria Pub Date : 2024-01-01 DOI:10.1016/j.gaceta.2024.102397

Wenqi Fu , Jufang Shi , Chaojie Liu , Wanqing Chen , Guoxiang Liu , Jie He

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引用次数: 0

Abstract

Objective

To determine the role of social health insurance programs in reducing inequality in the incidence and intensity of catastrophic health expenditure (CHE) of cancer patients in China.

Method

A convenient sample of 2534 cancer patients treated in nine hospitals in 2015 and 2016 were followed up through face-to-face interviews in March-December 2018. The incidence and intensity (mean positive overshoot) of CHE (≥ 40% household consumption) were calculated.

Results

About 72% of cancer patients experienced CHE events after insurance compensation, with the catastrophic mean positive overshoot amounting to 28.27% (SD: 15.83%) of the household consumption. Overall, social insurance contributed to a small percentage of drop in CHE events. Income-related inequality in CHE persisted before and after insurance compensation. Richer patients benefit more than poorer ones.

Conclusions

Cancer treatment is associated with high incidence of CHE events in China. The alleviating effect of social health insurance on CHE events is limited.

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医疗保险与癌症患者灾难性医疗支出的不平等。中国横断面研究

目的确定社会医疗保险项目在减少中国癌症患者灾难性医疗支出（CHE）发生率和强度不平等方面的作用。方法 2018年3月至12月，通过面对面访谈对2015年和2016年在9家医院接受治疗的2534名癌症患者进行了方便抽样随访。结果约72%的癌症患者在保险补偿后发生了CHE事件，灾难性平均正超支占家庭消费的28.27%（SD：15.83%）。总体而言，社会保险只导致了一小部分家庭消费支出的下降。在保险补偿前后，CHE 中与收入相关的不平等依然存在。结论在中国，癌症治疗与高发生率的 CHE 事件有关。结论在中国，癌症治疗与高CHE事件发生率相关，社会医疗保险对CHE事件的缓解作用有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gaceta Sanitaria 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.10

自引率

5.30%

发文量

审稿时长

29 days

期刊介绍： Gaceta Sanitaria (Health Gazette) is an international journal that accepts articles in Spanish and in English. It is the official scientific journal of the Sociedad Española de Salud Publica y Administración Sanitaria (Spanish Society of Public Health and Health Administration) (SESPAS). The Journal publishes 6 issues per year on different areas of Public Health and Health Administration, including: -Applied epidemiology- Health prevention and promotion- Environmental health- International health- Management and assessment of policies and services- Health technology assessments- Health economics. The editorial process is regulated by a peer review system. It publishes original works, reviews, opinion articles, field and methodology notes, protocols, letters to the editor, editorials, and debates.