Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study
Zhang, Jian-Gong1; Wang, Hong1; Gu, Xiao-Fen2; Wang, Xiao-Yang1; Wang, Wen-Jun3; Du, Ling-Bin4; Cao, He-Lu5; Zhang, Xi6; Shi, Ji-Hai7; Zhao, Yu-Qian8; Ma, Li9; Liu, Yun-Yong10; Huang, Juan-Xiu11; Cao, Ji12; Fan, Yan-Ping13; Li, Li14; Feng, Chang-Yan15; Zhu, Qian16; Du, Jing-Chang17; Wang, Xiao-Hui18; Han, Bin-Bin1; Qiao, You-Lin1,19
Corresponding AuthorHan, Bin-Bin(wenwxf006@126.com) ; Qiao, You-Lin(qiaoy@cicams.ac.cn)
AbstractBackground: The imbalanced allocation of medical resources leads to the occurrence of cross-regional healthcare-seeking in China. Due to the low cure rate, advanced colorectal cancer (CRC) patients may seek cross-regional healthcare for high-level medical facilities. Investigating status of cross-regional healthcare-seeking and its associated factors among advanced CRC patients is important for policymakers to understand access to health services and improve the quality of oncology services. Methods: From March 2020 to March 2021, a cross-sectional, nation-wide, hospital-based, multi-center survey was conducted. Nineteen hospitals in seven regions were selected by multi-stage stratified sampling.All eligible CRC patients in the selected hospitals were invited to participate in the current study. The outcome variable, cross-regional healthcare-seeking, was defined as seeking health facilities outside the local administration policy of medical insurance. The demographics, clinical information, and medical treatment history of each eligible CRC patient in stage III or IV, were collected through the patients' self-reporting or medical records by trained interviewers. Univariate and multivariate logistic analyses were used to explore the associated factors of cross-regional healthcare-seeking. All statistical analyses were conducted using SAS 9.4. Results: A total of 4,589 individuals with advanced CRC were included. The average age of the patients was 60.1 +/- 11.6 years, and 59.5% were males. About 37.5% of the patients suffered from metastatic CRC at first diagnosis. Approximately 36.5% of the patients had sought cross-regional health care previously, and among them, 31.9% had encountered problems. The most common problems included complicated procedures (95.3%), unreimbursed expenses of outpatient service (71.0%), and reimbursement delay (59.4%). Logistic regression analysis showed that patients who completed undergraduate or above [odds ratio (OR) =1.40, 95% confidence interval (CI): 1.13-1.73], had an annual household income of more than 100,000 Chinse Yuan (CNY) (OR =1.46, 95% CI: 1.21-1.78), and had metastasis at diagnosis (OR =1.33, 95% CI: 1.18-1.51) were more likely to seek cross-regional health care. Conclusions: About one third of advanced CRC patients seek cross-regional health care, and 31.9% had encountered problems. There is a need to simplify procedures of reimbursement, optimize direct settlement system and referral mechanisms in order to improve the equality of health services.
KeywordColorectal cancer (CRC) cross-regional healthcare-seeking cross-sectional study
Indexed BySCI
Funding ProjectBeijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
Funding OrganizationBeijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
WOS Research AreaOncology ; Research & Experimental Medicine
WOS SubjectOncology ; Medicine, Research & Experimental
WOS IDWOS:000777846400001
PublisherAME PUBL CO
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Document Type期刊论文
Corresponding AuthorHan, Bin-Bin; Qiao, You-Lin
Affiliation1.Zhengzhou Univ, Henan Canc Hosp, Dept Canc Epidemiol,Henan Engn Res Ctr Canc Preve, Henan Int Joint Lab Canc Prevent,Affiliated Canc, Zhengzhou 450008, Peoples R China
2.Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Student Affairs, Urumqi, Peoples R China
3.Jining Med Univ, Sch Nursing, Jining, Peoples R China
4.Univ Chinese Acad Sci, Canc Hosp, Zhejiang Canc Hosp, Dept Canc Prevent, Hangzhou, Peoples R China
5.Xinxiang Cent Hosp, Dept Prevent Hlth, Xinxiang, Henan, Peoples R China
6.Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Beijing Off Canc Prevent & Control, Minist Educ Beijing, Beijing, Peoples R China
7.Baotou Med Coll, Affiliated Hosp 1, Clin Epidemiol Res Ctr, Dept Dermatol, Baotou, Peoples R China
8.Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med, Chengdu, Peoples R China
9.Dalian Med Univ, Publ Hlth Sch, Dalian, Peoples R China
10.China Med Univ, Canc Hosp, Liaoning Canc Hosp & Inst, Liaoning Off Canc Control & Res, Shenyang, Peoples R China
11.Wuzhou Red Cross Hosp, Dept Gastroenterol, Wuzhou, Peoples R China
12.Guangxi Med Univ, Affiliated Hosp 1, Dept Canc Prevent & Control Off, Nanning, Peoples R China
13.Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Canc Ctr, Guangzhou, Peoples R China
14.Jinan Univ, Affiliated Hosp 1, Dept Clin Res, Guangzhou, Peoples R China
15.Chongqing Univ, Chongqing Key Lab Translat Res Canc Metastasis &, Canc Hosp, Chongqing, Peoples R China
16.Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China
17.Chengdu Med Coll, Sch Publ Hlth, Chengdu, Peoples R China
18.Gansu Prov Canc Hosp, Dept Publ Hlth, Lanzhou, Peoples R China
19.Chinese Acad Med Sci & Peking Union Med Coll, Ctr Global Hlth, Sch Populat Med & Publ Hlth, Beijing 100005, Peoples R China
Recommended Citation
GB/T 7714
Zhang, Jian-Gong,Wang, Hong,Gu, Xiao-Fen,et al. Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study[J]. ANNALS OF TRANSLATIONAL MEDICINE,2022.
APA Zhang, Jian-Gong.,Wang, Hong.,Gu, Xiao-Fen.,Wang, Xiao-Yang.,Wang, Wen-Jun.,...&Qiao, You-Lin.(2022).Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study.ANNALS OF TRANSLATIONAL MEDICINE.
MLA Zhang, Jian-Gong,et al."Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study".ANNALS OF TRANSLATIONAL MEDICINE (2022).
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