Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC...Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spen展开更多
目的:应用Walker经典概念分析法分析癌症相关经济毒性概念的定义及其内涵。方法:检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、OVID、EMbase等数据库中癌症相关经济毒性的相关文献,采用Walker概念分...目的:应用Walker经典概念分析法分析癌症相关经济毒性概念的定义及其内涵。方法:检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、OVID、EMbase等数据库中癌症相关经济毒性的相关文献,采用Walker概念分析方法对经济毒性的概念进行分析。结果:共纳入37篇文献,癌症相关经济毒性的定义属性包括客观的经济负担和主观的经济困境,前置因素为接受癌症治疗时产生的直接或间接医疗费用,导致支出增加和治疗或康复期间的收入减少,后果为经济损失、主观幸福感降低、健康相关生活质量受损、治疗依从性降低、低质量的治疗和护理等。结论:癌症相关经济毒性给病人的治疗和生活带来了深远影响,护士应认识到癌症相关经济毒性的存在及其重要性,针对高风险人群构建并开展适合我国国情的干预计划,为降低癌症相关经济毒性发挥积极作用。展开更多
基金supported by the grants from the Beijing Hope Run Special Fund(#LC2012YF44)National Natural Science Foundation of China(No.81402740)+1 种基金Specialized Research Fund for the Doctoral Program of Higher Education(No.20131106120014)The National Health and Family Planning Committee of P.R.China
文摘Background: The increasing prevalence of colorectal cancer(CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.Methods: We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan(CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup(hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.Results: A total of 2356 patients with a mean age of 57.4 years were included, 57.1 % of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY.The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3%of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups(P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spen
基金国家自然科学基金青年科学基金项目,编号:72004034China Medical Board Open Competition Program,编号:20⁃371+2 种基金上海市“科技创新行动计划”软科学重点项目,编号:20692104800上海市浦江人才计划,编号:2019PJC017上海市高水平地方高校试点建设项目“健康中国视角下循证护理创新研究院”子项目,编号:FNDGJ202005。
文摘目的:应用Walker经典概念分析法分析癌症相关经济毒性概念的定义及其内涵。方法:检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、OVID、EMbase等数据库中癌症相关经济毒性的相关文献,采用Walker概念分析方法对经济毒性的概念进行分析。结果:共纳入37篇文献,癌症相关经济毒性的定义属性包括客观的经济负担和主观的经济困境,前置因素为接受癌症治疗时产生的直接或间接医疗费用,导致支出增加和治疗或康复期间的收入减少,后果为经济损失、主观幸福感降低、健康相关生活质量受损、治疗依从性降低、低质量的治疗和护理等。结论:癌症相关经济毒性给病人的治疗和生活带来了深远影响,护士应认识到癌症相关经济毒性的存在及其重要性,针对高风险人群构建并开展适合我国国情的干预计划,为降低癌症相关经济毒性发挥积极作用。
