Financial burden on the families of patients with hepatitis B virus-related liver diseases and the role of public health insurance in Yunnan province of China.
OBJECTIVE
To investigate the financial burden of patients who had various stages of hepatitis B virus-related diseases and the level of alleviation from financial burden by health insurance schemes in Yunnan province of China.


METHODS
A cross-sectional survey.


METHODS
Patients' information was consecutively recorded at the First Affiliated Hospital of Kunming Medical University, from December 2012 to June 2013. Consecutive cases of hepatitis B virus (HBV) (520), compensated cirrhosis (91), decompensated cirrhosis (198) and hepatocellular carcinoma (HCC) (131) were recruited from the outpatient and inpatient departments. The total direct costs, hospital charge, outpatient costs, hospitalization fees being reimbursed and household catastrophic health expenditure were estimated for each disease group.


RESULTS
The average annual direct costs for each disease group were 19,496 RMB for HBV, 28,466 RMB in compensated cirrhosis, 46,061 RMB for decompensated cirrhosis, and 33,044 RMB for HCC patients. Catastrophic health expenditure occurred in all four groups. Health insurance reimbursement released the financial burden incurred by medical expenses of patients under a high level of household economic status. Public health insurance schemes helped the patients to various extents.


CONCLUSIONS
Among these patient groups, direct costs represent a significant economic burden. Health expenditure and financing systems must be considered to prevent the increase of household catastrophe, particularly among the poor.
The First Peoples' Hospital of Kunming City, Yunnan Province 650022, China.
Y H
YH
Che
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
V
V
Chongsuvivatwong
Department of Hepatobiliary Surgery, The First Peoples' Hospital of Kunming City, Yunnan Province 650022, China.
L
L
Li
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
H
H
Sriplung
Epidemiology and Biostatistics Unit, School of Public Health, Kunming Medical University, Yunnan Province 650032, China.
Y Y
YY
Wang
Department of Infectious Disease, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China. Electronic address: jingyoukm@126.com.
J
J
You
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
S J
SJ
Ma
Internal Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
Y
Y
Yan
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
R Y
RY
Zhang
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
T
T
Shen
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
H M
HM
Chen
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
S F
SF
Rao
The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.
X L
XL
Zhang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000821:virology; D002681:China; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000191:economics / Q000821:virology; D008107:Liver Diseases / Q000191:economics* / Q000821:virology; D008113:Liver Neoplasms / Q000191:economics / Q000821:virology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D055815:Young Adult
Catastrophic; Costs; Disease stage; Hepatitis B