Chinese Journal of Evidence-Based Pediatrics ›› 2023, Vol. 18 ›› Issue (1): 37-41.DOI: 10.3969/j.issn.1673-5501.2023.01.006

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Analysis of influencing factors of total medical expenses in children with newly diagnosed acute lymphoblastic leukemia during induction of remission

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YAO Xinyuan1, LIANG Xiaohua2, XIAO Li3, REN Yanling2, GAO Yong4, AN Xizhou1   

  1. Children's Hospital of Chongqing Medical University, Chongqing 400014, China; 1 Department of Hematology Oncology, National Center for Clinical Medical Research of Children's Health and Diseases, Key Laboratory of Pediatrics, Ministry of Education, Chongqing Key Laboratory of Pediatrics, 2 Epidemiology and Bioinformation Room, 3 Medical Record Statistics Department, 4 Logistics Management Office
  • Received:2022-06-05 Revised:2023-01-06 Online:2023-02-25 Published:2023-02-25
  • Contact: AN Xizhou, email:482240@hospital.cqmu.edu.cn

Abstract: Background:Family financial burden due to childhood acute lymphoblastic leukemia (ALL) is high. Objective:To explore the factors affecting the medical costs of children with ALL and to provide a basis for reasonable cost control. Design:Cross-sectional study. Methods:Children with newly diagnosed ALL were retrospectively enrolled at the Department of Hematology and Oncology of Children's Hospital of Chongqing Medical University. The total medical expenses during remission induction therapy were analyzed, and the factors affecting medical burden were analyzed using rank correlation analysis and generalized linear model statistics. Main outcome measures:The total hospitalization costs during the remission induction course in children with ALL. Results:A total of 1 081 children with newly diagnosed ALL were included in this analysis, including 622 males (57.5%) and 459 females with an average age of (70.5±44.5) months. The average total cost of diagnosis and treatment in the remission induction course was 59 860 yuan, the average daily hospitalization cost was (1 244±581) yuan, and the average blood product transfusion cost was (7 106±5 391) yuan. Univariate rank correlation coefficients showed there was a statistically significant difference between the medical costs during the remission induction and age, disease immunotype, risk stratification at initial diagnosis, nosocomial infection, fungal infection and sepsis, non-hematology admission, PICU admission, length of hospitalization and cost of blood product transfusion. Generalized linear model construction indicated that transfer to PICU, non-hematology admission, nosocomial infection, immunotype, fungal infection, length of hospital stay and cost of blood transfusion were independent risk factors affecting the total medical expenses in the remission induction course. Conclusions:The medical costs of ALL children were influenced by disease severity, complication severity, and factors related to medical management such as nosocomial infection and specialty admissions.

Key words: Acute lymphoblastic leukemia, Children, Medical costs, Influencing factors, Fungal infection, Intensive care unit