Analysis of hospitalization expenditure and its influencing factors for lung cancer patients in China: a research based on the “System of Health Accounts 2011”
Abstract Background At present, lung cancer is the common malignant tumor of respiratory system worldwide. The disease poses a serious health threat and a substantial economic burden to patients. The economic risks brought by lung cancer arouses widespread public concern. Therefore, the target of this research is to calculate lung cancer expenditure in China under the framework of the System of Health Account 2011 (SHA 2011). Intensive studies on working mechanism of influencing factors to lung cancer expenditure will be further explored, in order to achieve the goal of controlling lung cancer expenditure.Methods A multistage stratified sampling method was conducted in Liaoning province in China, and a total of 23559 patients were included into hospitalization expenditure analysis according to the framework of SHA 2011. The relation between the total hospitalization expenditure of lung cancer and its influencing factors including of demographic characteristics, diagnosis and treatment, and hospital condition was analyzed with the multiple stepwise regression analysis. The impact mechanism of these influencing factors was revealed through path analysis and survival analysis.Results The total hospitalization expenditure of lung cancer was $ 1581.8. Multiple stepwise regression analysis indicated that the total hospitalization expenditure was associated with length of stay, surgery, hospital level, insurance status, and hospital type, according to the sequence of standardized estimate (β). Length of stay contributed the most to the model R-square. Path analysis showed that surgery, hospital type, and insurance status not only made a direct impact on the hospitalization expenditure, but also made an indirect impact on it through the length of stay. Through survival analysis, we found self-funded patients of lung cancer were quicker to run out of the affordable money.Conclusions Lung cancer brought a heavy economic burden for patients. More efficient and stringent clinical control strategies should be conducted to limit the increase of the expenditure.