Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study

doi:10.21037/atm-22-1003

	Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study
	Zhang, Jian-Gong 1; Wang, Hong 1; Gu, Xiao-Fen 2; Wang, Xiao-Yang 1; Wang, Wen-Jun 3; Du, Ling-Bin 4; Cao, He-Lu 5; Zhang, Xi 6; Shi, Ji-Hai 7; Zhao, Yu-Qian 8
刊名	ANNALS OF TRANSLATIONAL MEDICINE
	2022-03-21
关键词	Colorectal cancer (CRC) cross-regional healthcare-seeking cross-sectional study
ISSN号	2305-5839
DOI	10.21037/atm-22-1003
通讯作者	Han, Bin-Bin(wenwxf006@126.com) ; Qiao, You-Lin(qiaoy@cicams.ac.cn)
英文摘要	Background: 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.
资助项目	Beijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
WOS关键词	HOSPITAL CHOICE ; BYPASS
WOS研究方向	Oncology ; Research & Experimental Medicine
语种	英语
出版者	AME PUBL CO
WOS记录号	WOS:000777846400001
资助机构	Beijing Love Book Cancer Foundation ; Merck Serono Co. Ltd.
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/128721]
专题	中国科学院合肥物质科学研究院
通讯作者	Han, Bin-Bin; Qiao, You-Lin
作者单位	1.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
推荐引用方式 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).