The Universal Zero Markup Drug Policy and Gastric Cancer Hospitalization Expenses: An Analysis of Trends and Influencing Factors in Shanghai from 2014 to 2021

Abstract

Abstract Background The increasing hospitalization expenses for Gastric Cancer (GC) cause a serious economic burden on society. Although the Chinese government has implemented the Universal Zero Markup Drug Policy (UZMDP) to control the growth of hospitalization expenditures, they remain a rising trend. It’s crucial to identify the factors influencing the hospitalization expenses of GC patients. This study aimed to analyze the trends and factors influencing hospitalization expenses of GC patients in Shanghai from 2014 to 2021. Methods Study data were sourced from the Health Network of Shanghai Economic Information Center. We employed interrupted time series analysis (ITSA) to analyze the trends in various medical expenditures before and after the implementation of UZMDP. The degree of association between various medical expenditures and hospitalization expenditures of GC patients was calculated by using the new gray relational analysis (GRA). Furthermore, we used multiple linear regression to identify the influencing factors of hospitalization expenses for GC patients. Results Our study included a total of 23,335 participants. The ITSA results showed an increasing trend in hospitalization expenses following the implementation of UZMDP. Drug expenses decreased instantaneously with the implementation of UZMDP, but subsequently began to trend upwards. After UZMDP, the expenses of medical consumables, examinations, and healthcare services all showed an upward trend. The new GRA indicated that the influencing factors of hospitalization expenses were drug expenses, consumable expenses, healthcare service expenses, and examination expenses in sequence. Multiple linear regression analysis showed that GC patients aged 60 or below had lower hospitalization expenses (Coefficient=-780.06, P = 0.0398). However, factors influencing increased hospitalization expenses included longer length of stay (Coefficient = 1753.01, P < 0.001), surgeries (Coefficient = 29047.26, P < 0.001), and hospitalization in the tertiary hospitals (Coefficient = 25485.19, P < 0.001) or secondary hospitals (Coefficient = 17755.12, P < 0.001). Conclusions Hospitalization expenses of GC patients in Shanghai have been rising annually from 2014 to 2021. Despite the implementation of the UZMDP policy, drug expenses remain a major factor in escalating hospitalization expenses. The hospitalization expenses of GC patients are significantly influenced by several factors, including the demographic characteristics of patients, the severity of diseases, and the levels of hospitals. These findings provide a scientific basis for effectively managing the hospitalization expenses of GC.