Does pathologic type shape the hospitalization costs of advanced non- small cell lung cancer patients? A multicenter real-world data study

Abstract

Abstract Background:Lung cancer represents the highest incidence and mortality rates among all cancers in China. Limited studies have explored the hospitalization costs of advanced non-small cell lung cancer (NSCLC) among Chinese. This study aims to outline the hospitalization costs of NSCLC patients, differentiate influencing factors, examine different pathological types affecting hospitalization costs and evaluate influencing factors respectively. Methods: In this real-world, multicenter, retrospective study, we collected electronic medical record data from January 2017 to December 2020 in two types of hospitals: comprehensive hospitals and specialized oncology hospitals. A total of 5362 patients were included. Patients' information on sociodemographic characteristics, disease-related characteristics, healthcare service utilization, and hospitalization costs were collected. Descriptive analysis, the Wilcoxon rank-sum test, and the generalized linear model were employed. Results: The median hospitalization cost among advanced NSCLC patients was $17,254 per capita, with drug costs as the highest cost. The hospitalization cost among patients with non-squamous carcinoma ($18,003) was significantly higher than that among patients with squamous carcinoma ($15,024), and pathological type significantly influenced the costs (β=0.098, p<0.001). Common influencing factors of hospitalization costs for both types included health insurance, hospital type, department, hospitalization frequency, and average length of hospital stay. The varying significant factors comprised age, gender, and occupation type among non-squamous carcinoma patients, whereas these factors were not notable among squamous carcinoma patients. Conclusion: Hospitalization costs pose a substantial economic burden on advanced NSCLC patients in China, particularly for the non-squamous carcinoma. The higher costs hinder adequate utilization and appropriate treatment among vulnerable populations.