Association of public health insurance with cancer-specific mortality risk among patients with nasopharyngeal carcinoma

A prospective cohort study in China

Bibliographic Data

ID22079643
AuthorsDan Li (0009-0009-7330-3225, Chongqing University), Hai-Ke Lei (Chongqing University), Xiao-Lei Shu, Xiaolei Shu (Chongqing University), Xin Zhang (0000-0003-0184-5868, Chongqing University), Hong-Lei Tu, Honglei Tu (0000-0003-3313-9335, Chongqing University), Feng Wang (0000-0003-4825-1151, Chongqing University), Yuwei Wang (0009-0000-6869-7105, Chongqing University), Yu-Wei Wang (0000-0002-1943-4074, Chongqing University, corresponding author), Ying Wang (0000-0003-3126-1134, Chongqing University, corresponding author), Jiang-Dong Sui (0000-0001-5171-1978, Chongqing University, corresponding author)
Year2023
Volume11
Pages1020828-1020828
Publication date2023-06-02
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2023.1020828
PMID37333541
OpenAlexW4379233403
LanguageEN
Citations received1
References cited28

Objective Health insurance programs are effective in preventing financial hardship in patients with cancer. However, not much is known about how health insurance policies, especially in Southwest China with a high incidence of nasopharyngeal carcinoma (NPC), influence patients’ prognosis. Here, we investigated the association of NPC-specific mortality with health insurance types and self-paying rate, and the joint effect of insurance types and self-paying rate. Materials and methods This prospective cohort study was conducted at a regional medical center for cancer in Southwest China and included 1,635 patients with pathologically confirmed NPC from 2017 to 2019. All patients were followed up until May 31, 2022. We determine the cumulative hazard ratio of all-cause and NPC-specific mortality in the groups of various insurance kinds and the self-paying rate using Cox proportional hazard. Results During a median follow-up period of 3.7 years, 249 deaths were recorded, of which 195 deaths were due to NPC. Higher self-paying rate were associated with a 46.6% reduced risk of NPC-specific mortality compared to patients with insufficient self-paying rate (HR: 0.534, 95% CI: 0.339–0.839, p = 0.007). For patients covered by Urban and Rural Residents Basic Medical Insurance (URRMBI), and for patients covered by Urban Employee Basic Medical Insurance, each 10% increase in the self-paying rate reduced the probability of NPC-specific death by 28.3 and 25%, respectively (UEBMI). Conclusion Results of this study showed that, despite China’s medical security administration improved health insurance coverage, NPC patients need to afford the high out-of-pocket medical costs in order to prolong their survival time

Cancer · China · Cohort · Cohort study · Environmental health · Health care · Health insurance · Nasopharyngeal carcinoma · Pathology · Political science · Prospective cohort study · Public health · Radiation therapy · Economic and Financial Impacts of Cancer · Head and Neck Cancer Studies · Healthcare Systems and Reforms · Medicine · Internal Medicine · Oncology