Background
Methods
Data collection
Data analysis
Ethics, consent and permissions
Results
Characteristics of subjects surveyed and ICC cases
Grouping criteria | Hospital admissions (person-times) | Subjects surveyed (×1000) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Males | Females | Urban | Rural | Total | Males | Females | Urban | Rural | |
Age (years) | ||||||||||
Under 45 | 70 | 14 | 56 | 48 | 22 | 31.05 | 15.42 | 15.63 | 16.08 | 14.96 |
45 to 54 | 62 | 29 | 33 | 37 | 25 | 10.45 | 4.88 | 5.57 | 5.40 | 5.06 |
55 to 64 | 100 | 67 | 33 | 42 | 58 | 9.81 | 4.90 | 4.91 | 4.64 | 5.18 |
65 to 74 | 44 | 33 | 11 | 22 | 22 | 6.06 | 3.19 | 2.86 | 2.92 | 3.14 |
75 or over | 42 | 35 | 7 | 22 | 20 | 3.31 | 1.58 | 1.73 | 1.57 | 1.74 |
Type of health insurance | ||||||||||
NCMC | 126 | 73 | 51 | 35 | 91 | 35.69 | 17.32 | 18.37 | 12.77 | 22.92 |
CEMI | 42 | 18 | 22 | 41 | 0 | 6.82 | 3.87 | 2.95 | 6.34 | 0.48 |
CRMI | 39 | 9 | 34 | 37 | 1 | 6.26 | 2.78 | 3.48 | 5.66 | 0.60 |
URMI | 13 | 9 | 4 | 2 | 11 | 4.92 | 2.40 | 2.52 | 1.71 | 3.21 |
Others | 16 | 9 | 7 | 11 | 4 | 6.98 | 3.61 | 3.37 | 4.12 | 2.86 |
Household income (quartile) | ||||||||||
Q1 | 53 | 27 | 26 | 18 | 33 | 10.75 | 5.32 | 5.43 | 4.68 | 6.07 |
Q2 | 70 | 23 | 49 | 48 | 22 | 19.19 | 9.39 | 9.80 | 8.92 | 10.27 |
Q3 | 78 | 45 | 32 | 42 | 36 | 16.80 | 8.28 | 8.52 | 9.08 | 7.73 |
Q4 | 72 | 37 | 33 | 48 | 26 | 13.88 | 6.96 | 6.92 | 7.88 | 6.01 |
Education | ||||||||||
No education | 41 | 19 | 22 | 22 | 20 | 17.51 | 6.53 | 10.97 | 7.28 | 10.23 |
Primary school | 73 | 39 | 26 | 23 | 49 | 16.55 | 8.30 | 8.25 | 7.28 | 9.27 |
Middle school | 71 | 41 | 20 | 35 | 38 | 16.62 | 9.40 | 7.22 | 8.69 | 7.93 |
Secondary or higher school | 58 | 21 | 33 | 55 | 6 | 10.00 | 5.75 | 4.25 | 7.35 | 2.65 |
Total | 257 | 121 | 135 | 146 | 111 | 60.68 | 29.98 | 30.70 | 30.60 | 30.08 |
Person-times and person-days of ICC per thousand population
Grouping criteria | Person-times of hospital admissions | Person-days of hospital stay | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total | Males (M) | Females (F) | P (M vs. F) | Urban | Rural | P (U vs. R) | Total | Males | Females | P (M vs F) | Urban | Rural | P (U vs R) | |
Age (years) | ||||||||||||||
Under 45 | 2.25 | 0.91 | 3.58 | <0.001 | 2.98 | 1.47 | 0.005 | 34.05 | 23.35 | 44.61 | <0.001 | 31.63 | 36.63 | <0.001 |
45 to 54 | 5.93 | 5.94 | 5.93 | 0.994 | 6.86 | 4.94 | 0.202 | 126.40 | 143.10 | 111.70 | <0.001 | 168.64 | 81.26 | <0.001 |
55 to 64 | 10.19 | 13.67 | 6.72 | 0.001 | 9.06 | 11.20 | 0.291 | 180.98 | 233.13 | 128.91 | <0.001 | 191.34 | 171.75 | <0.001 |
65 to 74 | 7.26 | 10.34 | 3.84 | 0.003 | 7.54 | 7.00 | 0.805 | 158.80 | 219.21 | 91.49 | <0.001 | 157.08 | 160.46 | 0.405 |
75 or over | 12.69 | 22.11 | 4.06 | <0.001 | 14.05 | 11.47 | 0.509 | 233.54 | 382.28 | 97.33 | <0.001 | 275.21 | 196.21 | <0.001 |
P (value) | <0.001 | <0.001 | 0.026 | NA | <0.001 | <0.001 | NA | <0.001 | <0.001 | <0.001 | NA | <0.001 | <0.001 | NA |
Type of health insurance | ||||||||||||||
NCMC | 3.53 | 4.22 | 2.78 | 0.021 | 2.74 | 3.97 | 0.061 | 54.87 | 63.05 | 45.72 | <0.001 | 43.51 | 60.90 | 0.032 |
CEMI | 6.16 | 4.65 | 7.46 | 0.131 | 6.47 | 0.00 | 0.076 | 145.62 | 152.11 | 135.65 | <0.001 | 154.34 | 34.08 | <0.001 |
CRMI | 6.23 | 3.24 | 9.76 | 0.002 | 6.54 | 1.66 | 0.142 | 74.68 | 83.85 | 80.73 | <0.001 | 80.74 | 16.05 | <0.001 |
URMI | 2.64 | 3.75 | 1.59 | 0.139 | 1.17 | 3.43 | 0.142 | 86.95 | 137.16 | 45.82 | <0.001 | 32.30 | 116.34 | <0.001 |
Others | 2.29 | 2.49 | 2.07 | 0.714 | 2.67 | 1.40 | 0.259 | 61.25 | 56.23 | 61.65 | <0.001 | 56.18 | 61.44 | <0.001 |
P (value) | <0.001 | 0.537 | <0.001 | NA | <0.001 | 0.125 | NA | <0.001 | <0.001 | <0.001 | NA | <0.001 | <0.001 | NA |
Household income (quartile) | ||||||||||||||
Q1 | 4.93 | 5.08 | 4.79 | 0.828 | 3.85 | 5.44 | 0.235 | 63.51 | 66.98 | 58.44 | <0.001 | 47.75 | 73.02 | <0.001 |
Q2 | 3.65 | 2.45 | 5.00 | 0.004 | 5.38 | 2.14 | <0.001 | 53.17 | 48.67 | 58.08 | 0.051 | 72.82 | 35.64 | <0.001 |
Q3 | 4.64 | 5.43 | 3.76 | 0.116 | 4.63 | 4.66 | 0.769 | 73.91 | 85.42 | 61.15 | <0.001 | 69.73 | 78.88 | 0.083 |
Q4 | 5.19 | 5.32 | 4.77 | 0.603 | 6.10 | 4.33 | 0.092 | 144.32 | 160.27 | 129.58 | <0.001 | 157.88 | 133.54 | <0.001 |
P (value) | <0.001 | <0.001 | 0.021 | NA | 0.008 | <0.001 | NA | <0.001 | <0.001 | <0.001 | NA | <0.001 | <0.001 | NA |
Education | ||||||||||||||
No education | 2.34 | 2.91 | 2.01 | 0.232 | 3.02 | 1.96 | 0.155 | 47.00 | 45.47 | 44.70 | 0.378 | 50.09 | 45.28 | 0.052 |
Primary school | 4.41 | 4.70 | 3.15 | 0.112 | 3.16 | 5.28 | 0.039 | 74.65 | 76.13 | 62.51 | <0.001 | 52.94 | 91.74 | <0.001 |
Middle school | 4.27 | 4.36 | 2.77 | 0.092 | 4.03 | 4.79 | 0.457 | 86.66 | 100.52 | 39.69 | <0.001 | 88.96 | 81.11 | <0.001 |
Secondary or higher school | 5.80 | 3.65 | 7.76 | 0.006 | 7.48 | 2.26 | 0.003 | 108.23 | 93.19 | 119.02 | <0.001 | 140.40 | 13.03 | <0.001 |
P (value) | <0.001 | 0.327 | <0.001 | NA | <0.001 | <0.001 | NA | <0.001 | <0.001 | <0.001 | NA | <0.001 | <0.001 | NA |
Total | 4.24 | 4.04 | 4.40 | 0.492 | 4.77 | 3.69 | 0.040 | 76.78 | 82.97 | 70.50 | <0.001 | 82.52 | 71.97 | <0.001 |
ICC expenditures by cancer types and population groups
Expenditures on inpatient care for cancers vs. all diseases
Grouping criteria | Direct expenditure (%) | Indirect expenditure (%) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Males | Females | Urban | Rural | Total | Males | Females | Urban | Rural | |
Age (years) | ||||||||||
Under 45 | 13.91 | 12.98 | 14.83 | 15.10 | 12.76 | 17.19 | 17.38 | 17.06 | 18.15 | 16.32 |
45 to 54 | 21.82 | 21.02 | 22.55 | 24.51 | 18.60 | 22.90 | 28.22 | 17.99 | 30.55 | 15.16 |
55 to 64 | 18.56 | 22.05 | 14.46 | 19.43 | 17.55 | 12.13 | 11.37 | 13.14 | 12.23 | 12.06 |
65 to 74 | 11.72 | 16.89 | 6.26 | 8.91 | 16.36 | 11.94 | 16.51 | 6.57 | 5.99 | 19.07 |
75 or over | 16.84 | 23.23 | 7.65 | 14.75 | 21.72 | 15.40 | 19.27 | 8.92 | 13.83 | 17.19 |
Type of health insurance | ||||||||||
NCMC | 9.42 | 9.07 | 8.12 | 7.36 | 10.35 | 8.70 | 8.49 | 7.99 | 7.10 | 9.41 |
CEMI | 19.75 | 16.87 | 23.48 | 20.31 | 8.48 | 21.45 | 20.61 | 24.90 | 22.52 | 1.80 |
CRMI | 17.01 | 20.88 | 16.26 | 16.99 | 13.60 | 12.77 | 11.46 | 14.89 | 12.82 | 10.96 |
URMI | 17.76 | 14.41 | 9.69 | 4.36 | 25.21 | 13.53 | 15.45 | 8.67 | 6.43 | 18.59 |
Others | 17.03 | 14.23 | 18.21 | 20.10 | 10.14 | 14.05 | 12.41 | 15.09 | 11.39 | 18.99 |
Household income (quartile) | ||||||||||
Q1 | 8.17 | 2.53 | 12.84 | 7.28 | 8.70 | 6.49 | 2.20 | 9.03 | 5.44 | 7.19 |
Q2 | 16.89 | 10.29 | 23.38 | 21.81 | 12.06 | 18.30 | 9.86 | 25.33 | 26.06 | 10.63 |
Q3 | 12.91 | 11.98 | 10.52 | 13.18 | 12.41 | 8.89 | 9.68 | 7.20 | 5.30 | 12.46 |
Q4 | 16.73 | 16.51 | 14.44 | 17.78 | 16.44 | 16.44 | 16.62 | 15.63 | 17.27 | 15.74 |
Education | ||||||||||
No education | 11.78 | 10.58 | 13.07 | 12.36 | 12.48 | 8.35 | 9.01 | 9.24 | 8.46 | 9.54 |
Primary school | 13.47 | 11.79 | 12.03 | 10.66 | 17.28 | 15.38 | 12.45 | 18.91 | 11.15 | 20.31 |
Middle school | 13.48 | 13.06 | 9.56 | 13.32 | 13.52 | 7.78 | 8.30 | 4.53 | 6.21 | 9.55 |
Secondary or higher school | 19.76 | 15.41 | 7.63 | 25.23 | 3.23 | 24.21 | 24.77 | 21.82 | 30.18 | 3.77 |
Total | 13.30 | 11.11 | 13.34 | 14.18 | 12.49 | 12.70 | 10.97 | 13.56 | 13.41 | 11.99 |
Catastrophic features of ICC expenditures
Grouping criteria | Direct expenditure meeting given % income | Total expenditure meeting given % income | ||||||
---|---|---|---|---|---|---|---|---|
20 % | 30 % | 40 % | 50 % | 20 % | 30 % | 40 % | 50 % | |
Age (years) | ||||||||
Under 45 | 21.4 | 17.1 | 14.3 | 12.9 | 22.9 | 20.0 | 20.0 | 15.7 |
45 to 54 | 41.9 | 32.3 | 27.4 | 22.6 | 51.6 | 41.9 | 33.9 | 27.4 |
55 to 64 | 30.0 | 22.0 | 18.0 | 14.0 | 36.0 | 26.0 | 24.0 | 18.0 |
65 to 74 | 56.8 | 43.2 | 43.2 | 38.6 | 59.1 | 50.0 | 43.2 | 43.2 |
75 or over | 35.7 | 19.0 | 14.3 | 14.3 | 40.5 | 21.4 | 19.0 | 14.3 |
P value | 0.002 | 0.012 | 0.002 | 0.004 | 0.001 | 0.002 | 0.034 | 0.003 |
Gender | ||||||||
Males | 26.6 | 18.4 | 16.4 | 14.0 | 30.0 | 21.6 | 20.1 | 16.9 |
Females | 24.3 | 19.7 | 15.6 | 13.6 | 29.3 | 24.4 | 20.7 | 16.1 |
P value | 0.062 | 0.490 | 0.298 | 0.486 | 0.103 | 0.658 | 0.314 | 0.240 |
Region | ||||||||
Urban | 22.0 | 16.1 | 14.0 | 12.8 | 26.0 | 19.9 | 17.0 | 14.5 |
Rural | 31.0 | 23.1 | 19.1 | 15.5 | 35.2 | 27.5 | 25.4 | 19.7 |
P value | 0.070 | 0.091 | 0.126 | 0.348 | 0.075 | 0.161 | 0.082 | 0.188 |
Type of health insurance | ||||||||
NCMC | 27.8 | 18.8 | 15.4 | 12.4 | 31.7 | 23.8 | 21.1 | 16.3 |
CEMI | 9.2 | 8.6 | 7.6 | 7.6 | 12.8 | 9.2 | 8.6 | 8.6 |
CRMI | 20.5 | 14.8 | 11.4 | 9.1 | 24.3 | 16.8 | 14.8 | 9.1 |
URMI | 50.1 | 41.9 | 38.6 | 36.0 | 50.1 | 45.6 | 45.6 | 38.6 |
Others | 81.1 | 65.2 | 57.2 | 46.8 | 88.3 | 80.4 | 65.2 | 57.2 |
P value | <0.001 | <0.001 | <0.001 | 0.001 | <0.001 | <0.001 | <0.001 | <0.001 |
Household income (quartile) | ||||||||
Q1 | 20.4 | 14.9 | 12.9 | 12.5 | 22.5 | 17.0 | 16.6 | 12.9 |
Q2 | 23.0 | 20.5 | 18.1 | 15.7 | 32.4 | 24.0 | 19.6 | 17.1 |
Q3 | 41.7 | 26.8 | 21.0 | 15.7 | 44.5 | 33.1 | 31.1 | 22.5 |
Q4 | 21.5 | 14.8 | 12.6 | 11.4 | 23.7 | 17.3 | 13.7 | 13.7 |
P value | 0.008 | 0.091 | 0.103 | 0.123 | 0.005 | 0.031 | 0.012 | 0.153 |
Level of hospital | ||||||||
Township | 15.4 | 7.7 | 7.7 | 7.7 | 23.1 | 7.7 | 7.7 | 7.7 |
County | 31.1 | 20.5 | 17.2 | 14.8 | 37.7 | 24.6 | 21.3 | 17.2 |
Prefecture | 43.4 | 31.9 | 26.5 | 23.9 | 46.9 | 39.8 | 34.5 | 29.2 |
Provence | 31.4 | 27.1 | 25.7 | 20.0 | 35.7 | 30.0 | 28.6 | 22.9 |
P value | 0.076 | 0.098 | 0.164 | 0.228 | 0.222 | 0.025 | 0.062 | 0.104 |
Education | ||||||||
No education | 26.8 | 21.5 | 19.6 | 19.1 | 32.7 | 25.8 | 23.8 | 20.2 |
Primary school | 21.2 | 15.5 | 14.0 | 11.2 | 23.0 | 18.5 | 16.2 | 13.3 |
Middle school | 28.6 | 17.5 | 11.2 | 7.6 | 35.5 | 21.9 | 16.7 | 12.4 |
Secondary or higher school | 19.4 | 16.0 | 14.5 | 14.5 | 21.0 | 17.9 | 16.0 | 16.0 |
P value | 0.001 | 0.010 | 0.006 | 0.001 | <0.001 | 0.003 | 0.003 | 0.019 |
Total | 25.9 | 19.1 | 16.3 | 14.0 | 30.0 | 23.1 | 20.6 | 16.7 |
Multivariate regression analysis of ICC expenditures
Factors | Direct expenditure | Indirect expenditure | Total expenditure | ||||||
---|---|---|---|---|---|---|---|---|---|
B | t | P | B | t | P | B | t | P | |
Constant | 1.611 | 8.404 | <0.001 | 0.805 | 2.386 | 0.018 | 1.630 | 7.688 | <0.001 |
Age | 0.000 | 0.458 | 0.648 | 0.002 | 1.680 | 0.094 | 0.000 | 0.658 | 0.511 |
Gender | −0.025 | −1.664 | 0.097 | 0.032 | 1.278 | 0.202 | −0.010 | −0.607 | 0.544 |
Region | 0.006 | 0.441 | 0.659 | 0.064 | 2.631 | 0.009 | 0.011 | 0.708 | 0.479 |
Education | −0.021 | −2.715 | 0.007 | 0.005 | 0.399 | 0.690 | −0.018 | −2.090 | 0.037 |
Reimbursement ratio | 0.000 | 1.128 | 0.260 | −0.002 | −3.155 | 0.002 | −0.002 | −6.507 | <0.001 |
Ln (household income) | 0.233 | 2.882 | 0.004 | 0.356 | 2.514 | 0.012 | 0.236 | 2.643 | 0.009 |
Level of hospital | 0.068 | 7.768 | <0.001 | 0.080 | 5.284 | <0.001 | 0.066 | 6.865 | <0.001 |