Study On The Economic Burden Of Primary Liver Cancerin Guangxi From2010to2013

Objective: Analyse the economic burden of primary liver cancer (PLC) inGuangxi from2010to2013, to provide scientific evidence to support healthadministrative authorities in making health care policy decisions.Methods:1、Retrieved the medical record information of patients who hadhospital admission in Guangxi between Jan2010to Dec2013from the NationalHealth Statistical Information Network.2、Conducted face-to-face interviewsamong inpatients who had clinical diagnosis as primary liver cancer, by using aself-developed questionnaire-"Economic burden of patients’ hospital admissioncaused by primary liver cancer".3、Obtained information on the number ofdeaths by gender and age, from "The Third-round Investigation on Causes ofDeath among Guangxi Residents".4、Gathered information on the years of lifelost (YLLs)、years lived with disability (YLDs)、disability adjusted life years(DALYs) of Chinese patients with hepatocellular carcinoma from the GlobalBurden of Disease Study2010(GBD2010). Statistical Package for the Social Sciences (SPSS16.0) and Excel softwarewere used to analyse the direct economic burden on inpatients with liver cancer.Factors associated with direct medical economic burden were explored bymultiple linear regression and rank-sum test. The indirect economic burden ofcancer was analysed through both population approach and family perspective.The indirect economic burden on patient populations was measured by DALYusing human capital approach (HCA); while the indirect economic burden onpatient families was measured by the lost earnings from disease-related loss inworking hours of patients and their accompanying relatives.Results1、In2013Guangxi overall，the incidence rate of PLC was20.41per100,000population,the maximum incidence of PLC occurred in the age group65yearsand older, the incidence rate was42.87per100,000population. In the age group15to64years, the incidence rate was23.60per100,000population, and in theage group14years and younger, the incidence rate was0.51per100,000population. In all age groups, the incidence of liver cancer of males weresignificantly higher than that of females, and the incidence of liver cancer formales is5.18times higher than that of females.2、 The total economic burden for patients with liver cancer in Guangxifrom2010to2013was6,329,155,800Chinese Yuan (CNY).The direct medicaleconomic burden of PLC inpatients were116,752,300CNY,148,170,400CNY,177,585,700CNY,177,757,200CNY, each year respectively within the periodfrom2010-2013，and the drug cost accounts for the largest proportion. Theindirect economic burden were1,139,083,600CNY,1,366,172,900CNY, 1,507,828,500CNY,1,656,550,800CNY,and the direct non-medical financialburden of inpatients with hepatocellular carcinoma in Guangxi was39,254,400CNY.3、Direct medical economic burden of inpatient with liver cancer in Guangxiranked the first among various malignancies and it increased yearly from2010to2013, continuously. Bronchus and lung cancer ranked the second, andnasopharyngeal cancer ranked the third.4、 In2013the expense of individual payment of PLC inpatients was60,574,000CNY. The total hospital admission expenses of PLC inpatients was177,753,800CNY, and the self out-of-pocket payments accounted for34.08%ofthe total expenditure.5、Sex, age, marital status, hospitalisation duration, hospitalisation frequency,surgery treatment, hospital infection, administrative regions, and medicalpayment type were the influencing factors of the direct medical economicburden of PLC inpatients, while hospitalisation days was the most importantfactor.Conclusions1、Economic burden of primary liver cancer in Guangxi was extremely serious.The most fundamental and effective measures of reducing the economic burdenof liver cancer is to control the incidence of the disease.2、Direct medical economic burden of inpatient with liver cancer in Guangxiranked the first among various malignancies and it increased yearly from2010 3、In2013the self out-of-pocket payments accounted for34.08%of the totalexpenditure, government investment in health finance should be increased, andpersonal health spending should be reduced.4、Hospitalisation days was the most important factor of the direct medicaleconomic burden of PLC inpatients,shorten hospitalisation days is the effectivemeasures to control direct medical economic burden.