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Objective <p>By analyzing the medical cost index and difference trend among inpatients with lung cancer who participated in the New Rural Cooperative Medical Scheme (NRCMS) in coastal areas and inland areas of Fujian Province from 2007 to 2016, we evaluated the medical cost burden and health security level of rural lung cancer patients in Fujian Province under the background of the NRCMS.</p> Methods <p>Medical record cost data of 88,191 inpatients with lung cancer under the NRCMS were collected from medical institutions at all levels in Fujian Province from 2007 to 2016. The mean and standard deviation of total hospitalization expenses, average daily hospitalization expenses, reimbursement ratio, and OOP ratio (the ratio of out-of-pocket expenditure and disposable income) for lung cancer patients in coastal areas and inland areas during 2007–2016 were calculated. After adjusting for sex, age, length of stay, and hospital level, the relative differences with 95% confidence intervals (CI) between coastal and inland areas in various cost indicators were calculated using generalized linear models to assess the trends in the differences over time.</p> Results <p>We found differences in the total hospitalization cost, average daily hospitalization cost, reimbursement ratio, and OOP ratio of lung cancer patients in coastal areas and inland areas of Fujian Province. The burden of medical expenses for lung cancer patients in coastal areas is relatively greater than that in inland areas. From 2007 to 2011, the difference in medical expenses for inpatients with lung cancer in coastal areas and inland areas gradually narrowed. However, from 2012 to 2014, the difference in medical expenses between the two regions gradually widened. From 2014 to 2016, the difference between the two regions gradually narrowed again, and in 2016, it returned to the difference level between the two regions in 2010.</p> Conclusions <p>Under the influence of the NRCMS, the hospitalization cost, average daily hospitalization cost, and OOP ratio of lung cancer patients in coastal areas were higher than those in inland areas from 2007 to 2016, but the reimbursement ratio was lower. In general, the medical expenses of lung cancer patients in coastal areas of Fujian Province are greater than those in inland areas, which may be affected by differences in the level of hospitals, treatment methods, drug scope, expected survival level, and medical assistance policies of lung cancer patients in the two regions.</p>

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Medical expenses of lung cancer patients under the New Rural Cooperative Medical Scheme in coastal and inland areas of Fujian Province from 2007 to 2016: differential trend analysis

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  • 发表日期：

    2025年4月25日

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  • Qiongting Liu,
  • Rong Fu,
  • Yixian Jiang,
  • Zhenquan Zheng,
  • Zhijian Hu,
  • Fei He

摘要

Objective

By analyzing the medical cost index and difference trend among inpatients with lung cancer who participated in the New Rural Cooperative Medical Scheme (NRCMS) in coastal areas and inland areas of Fujian Province from 2007 to 2016, we evaluated the medical cost burden and health security level of rural lung cancer patients in Fujian Province under the background of the NRCMS.

Methods

Medical record cost data of 88,191 inpatients with lung cancer under the NRCMS were collected from medical institutions at all levels in Fujian Province from 2007 to 2016. The mean and standard deviation of total hospitalization expenses, average daily hospitalization expenses, reimbursement ratio, and OOP ratio (the ratio of out-of-pocket expenditure and disposable income) for lung cancer patients in coastal areas and inland areas during 2007–2016 were calculated. After adjusting for sex, age, length of stay, and hospital level, the relative differences with 95% confidence intervals (CI) between coastal and inland areas in various cost indicators were calculated using generalized linear models to assess the trends in the differences over time.

Results

We found differences in the total hospitalization cost, average daily hospitalization cost, reimbursement ratio, and OOP ratio of lung cancer patients in coastal areas and inland areas of Fujian Province. The burden of medical expenses for lung cancer patients in coastal areas is relatively greater than that in inland areas. From 2007 to 2011, the difference in medical expenses for inpatients with lung cancer in coastal areas and inland areas gradually narrowed. However, from 2012 to 2014, the difference in medical expenses between the two regions gradually widened. From 2014 to 2016, the difference between the two regions gradually narrowed again, and in 2016, it returned to the difference level between the two regions in 2010.

Conclusions

Under the influence of the NRCMS, the hospitalization cost, average daily hospitalization cost, and OOP ratio of lung cancer patients in coastal areas were higher than those in inland areas from 2007 to 2016, but the reimbursement ratio was lower. In general, the medical expenses of lung cancer patients in coastal areas of Fujian Province are greater than those in inland areas, which may be affected by differences in the level of hospitals, treatment methods, drug scope, expected survival level, and medical assistance policies of lung cancer patients in the two regions.