Table_1_Health Care Utilization and Costs of Patients With Prostate Cancer in China Based on National Health Insurance Database From 2015 to 2017.docx

BackgroundIn terms of medical costs, prostate cancer is on the increase as one of the most costly cancers, posing a tremendous economic burden, but evidence on the health care utilization and medical expenditure of prostate cancer has been absent in China.ObjectiveThis study aimed to analyze health care utilization and direct medical costs of patients with prostate cancer in China.MethodsHealth care service data with a national representative sample of basic medical insurance beneficiaries between 2015 and 2017 were obtained from the China Health Insurance Association database. We conducted descriptive and statistical analyses of health care utilization, annual direct medical costs, and composition based on cancer-related medical records. Health care utilization was measured by the number of hospital visits and the length of stay.ResultsA total of 3,936 patients with prostate cancer and 24,686 cancer-related visits between 2015 and 2017 were identified in the database. The number of annual outpatient and inpatient visits per patient differed significantly from 2015 to 2017. There was no obvious change in length of stay and annual direct medical costs from 2015 to 2017. The number of annual visits per patient (outpatient: 3.0 vs. 4.0, P < 0.01; inpatient: 1.5 vs. 2.0, P < 0.001) and the annual medical direct costs per patient (US$2,300.1 vs. US$3,543.3, P < 0.001) of patients covered by the Urban Rural Resident Basic Medical Insurance (URRBMI) were both lower than those of patients covered by the Urban Employee Basic Medical Insurance (UEBMI), and the median out-of-pocket expense of URRBMI was higher than that of UEBMI (US$926.6 vs. US$594.0, P < 0.001). The annual direct medical costs of patients with prostate cancer in Western regions were significantly lower than those of patients in Eastern and Central regions (East: US$4011.9; Central: US$3458.6; West: US$2115.5) (P < 0.001).ConclusionsThere was an imbalanced distribution of health care utilization among regions in China. The direct medical costs of Chinese patients with prostate cancer remained stable, but the gap in health care utilization and medical costs between two different insurance schemes and among regions still needed to be further addressed.

背景：就医疗成本而言，前列腺癌作为成本最高的癌症之一，其发病率呈上升趋势，给社会经济带来了巨大的负担。然而，在中国，关于前列腺癌的医疗保健利用和医疗支出方面的证据一直缺失。目标：本研究旨在分析中国前列腺癌患者的医疗保健利用和直接医疗成本。方法：我们从中国医疗保险协会数据库中获取了2015年至2017年间具有全国代表性样本的基本医疗保险受益人的医疗保健服务数据。基于癌症相关医疗记录，我们对医疗保健利用、年度直接医疗成本及其构成进行了描述性和统计分析。医疗保健利用通过住院次数和住院时长来衡量。结果：在数据库中，2015年至2017年间共确定了3,936名前列腺癌患者和24,686次癌症相关就诊。患者每年的门诊和住院就诊次数在2015年至2017年间存在显著差异。从2015年到2017年，住院时长和年度直接医疗成本没有明显变化。URRBMI（城乡居民基本医疗保险）覆盖的患者的年度就诊次数（门诊：3.0 vs. 4.0，P < 0.01；住院：1.5 vs. 2.0，P < 0.001）和每位患者的年度直接医疗成本（US$2,300.1 vs. US$3,543.3，P < 0.001）均低于UEBMI（城镇职工基本医疗保险）覆盖的患者，而URRBMI的平均自付费用高于UEBMI（US$926.6 vs. US$594.0，P < 0.001）。西部地区前列腺癌患者的年度直接医疗成本显著低于东部和中部地区（东部：US$4011.9；中部：US$3458.6；西部：US$2115.5）（P < 0.001）。结论：中国各地区医疗保健利用分布不均。中国前列腺癌患者的直接医疗成本保持稳定，但不同保险方案和地区间在医疗保健利用和医疗成本方面的差距仍需进一步解决。