Su Jun, Zhang Yu-Qing, Shao Di, Wang Jia-Min, Hao Wei, Liu Yan-Xiu, Wang Long, Sun Xiao-Jie
Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, 250012, China.
Int J Equity Health. 2025 Mar 17;24(1):75. doi: 10.1186/s12939-025-02442-1.
Pediatric leukemia is the most prevalent childhood cancer in China, exerting a considerable financial impact on affected families. Despite the mandatory participation of all Chinese children in the Resident Basic Medical Insurance, out-of-pocket (OOP) expenses remain substantial for families of children with leukemia. However, charity assistance has been shown to help mitigate these financial burdens. The "Love Union Project" is a comprehensive charitable medical assistance program designed to support families of children with leukemia within China's multi-tiered healthcare security system. This study was designed to evaluate the impact of the "Love Union Project" on reducing the incidence of catastrophic health expenditure (CHE) among families of children with leukemia in China.
The study involved 85 children in the intervention group from H city and 36 matched control children from S and Y cities. Data on demographics, medical expenses, and assistance were collected. Non-normally distributed costs were reported as medians. Multivariate logistic regression analyzed the impact of the "Love Union Project" on CHE.
Thanks to the program's intervention, the CHE rate among the intervention group decreased from 75.3% to 65.9%, while the incidence of CHE in the control group was 75.0%. Compared to families with children aged 0-6 years, those aged 7-12 were more likely to incur CHE (OR 5.224; 95% confidence intervals 1.412-19.322). Families with five or more members were also at higher risk of CHE than those with four members or fewer (OR 2.847; 95% confidence intervals 1.056-7.676). Additionally, families with a monthly income of CNY8000($1,120) or more were less likely to experience CHE than those with a monthly income of CNY4000($560) or less (OR 0.257; 95% confidence intervals 0.072-0.923). Lastly, families receiving assistance from the "Love Union Project" reported significantly lower CHE rates than those who didn't receive such support (OR 0.151; 95% confidence intervals 0.044-0.524).
While medical insurance provides limited relief, the "Love Union Project" enhances economic resilience for families of children with leukemia. Attention should focus on younger patients, larger households, lower-income families, and those not receiving charity support.
儿童白血病是中国最常见的儿童癌症，给患病家庭带来了相当大的经济负担。尽管所有中国儿童都必须参加居民基本医疗保险，但白血病患儿家庭的自付费用仍然很高。然而，慈善援助已被证明有助于减轻这些经济负担。“爱佑新生项目”是一项综合性慈善医疗救助项目，旨在在中国多层次医疗保障体系内支持白血病患儿家庭。本研究旨在评估“爱佑新生项目”对降低中国白血病患儿家庭灾难性卫生支出（CHE）发生率的影响。
本研究纳入了来自H市的85名干预组儿童和来自S市及Y市的36名匹配对照组儿童。收集了人口统计学、医疗费用和援助方面的数据。非正态分布的费用以中位数报告。多因素logistic回归分析了“爱佑新生项目”对CHE的影响。
由于该项目的干预，干预组的CHE发生率从75.3%降至65.9%，而对照组的CHE发生率为75.0%。与0至6岁儿童的家庭相比，7至12岁儿童的家庭发生CHE的可能性更大（比值比5.224；95%置信区间1.412 - 19.322）。家庭成员为五人或更多的家庭发生CHE的风险也高于四人或更少成员的家庭（比值比2.847；95%置信区间1.056 - 7.676）。此外，月收入8000元（1120美元）或以上的家庭发生CHE的可能性低于月收入4000元（560美元）或以下的家庭（比值比0.257；95%置信区间0.072 - 0.923）。最后，接受“爱佑新生项目”援助的家庭报告的CHE发生率显著低于未接受此类支持的家庭（比值比0.151；95%置信区间0.044 - 0.524）。
虽然医疗保险提供的缓解有限，但“爱佑新生项目”增强了白血病患儿家庭的经济承受能力。应关注年龄较小的患者、大家庭、低收入家庭以及未获得慈善支持的家庭。
