Expenditure and Financial Burden for Stomach Cancer Diagnosis and Treatment in China: A Multicenter Study

Background: Stomach cancer is a huge threaten to the of Chinese people’s health. However, few studies were known about the expenditure and the financial burden of stomach cancer in China. Methods: To estimate the direct (medical and non-medical expenditure) and indirect expenditure for diagnosis and treatment for stomach cancer patients in China, a multicenter survey was conducted in 37 tertiary hospitals in 13 provinces across China from 2012 to 2014. Each enrolled patient was interviewed through a structured questionnaire. The medical and non-medical expenditure at different clinical stages, the composition of non-medical expenditure and time loss for the cancer patient and family were assessed. All expenditure data were inflated to the 2014 Chinese Yuan [CNY; 1 CNY = 0.163 USA dollar (USD)]. Results: A total of 2401 stomach cancer patients with a mean age of 58.1 ± 11.4 years were included, predominately male. The overall average direct expenditure per patient was estimated to be 60,731 CNY (medical expenditure 91.2%, non-medical expenditure 8.8%), and the expenditures for stage I, II, III, and IV were 55,484 CNY, 56,774 CNY, 61,965 CNY, and 69,564 CNY, respectively; expenditure in stage III and IV was significantly higher than that in stages I and II (P < 0.05). One-year out-of-pocket expenditure of a newly diagnosed patient with stomach cancer was 32,931 CNY, accounting for 63.8% of their previous-year household income, which led to 79.2% families suffering an unmanageable financial burden. The average loss of time for patients and caregivers was 6,108 CNY. Conclusions: This study indicated that economic burden for stomach cancer in urban China was onerous. Effective intervention needs to be taken to reduce the financial burden by decline personal payment ratio and increase the reimbursement ratio.