Medical expenses of urban Chinese patients with stomach cancer during 2002-2011: a hospital-based multicenter retrospective study.

BACKGROUND: In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients' medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients' medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends. METHODS: The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002-2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient. RESULTS: The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses. CONCLUSIONS: The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China.

Weight status in Chinese children: maternal perceptions and child self-assessments.

BACKGROUND: Inaccurate parental perceptions of child weight status as well as children's own misperceptions can reduce motivation to adopt optimal nutritional and physical activity behaviors, thereby increasing overweight and obesity risk in child populations in the U.S. and elsewhere. Using population-based data from nine provinces of China, we analyzed the accuracy of maternal perceptions and children's self-assessments of weight status. METHODS: The data were collected from 1265 children aged 6 to 18 years with self-reported weight status perceptions during the 2006 China Health and Nutrition Survey. Among these children, 863 had maternal estimation of child weight status. Descriptive and multiple regression analyses are conducted to find variations in the misperception of children's weight status. RESULTS: Among overweight children (n=176), 69% underestimated their weight status; 72% mothers of the overweight children (n=143) also underestimated their child's weight status. Less than one-quarter of overweight children and their mothers chose the correct classification of weight status. Multiple regression analyses showed that as children's body-mass-index (BMI)-for-age increased, the odds that mothers underestimated their weight status increased. Low maternal weight was significantly associated with maternal underestimation of child weight status but not with child's underassessment. CONCLUSIONS: Underestimation of childhood overweight is common among both mothers and children in China, particularly for children with the highest BMI. School-based BMI reporting may be beneficial in alerting parents and children to the problem and encouraging communication with health care providers.