County-based demographics, patterns of treatment seeking, and disease burden for malignant tumor patients in China.

Background: The mortality of malignant tumors in rural areas of China in 2015 was significantly higher than that in city areas (213.6 per 100,000 vs. 191.5 per 100,000), bringing huge economic pressure to individuals and the local community. The comprehensive reform of county-level public hospitals in Yun County has helped patients with critical disease receive appropriate treatment. Therefore, an analysis focused on the epidemiology and disease burden of malignant tumors in Yun County could provide guidance for administrators and health practitioners in other counties.

Methods: This retrospective database study extracted data from the Yun County medical community (including two higher level hospitals: Yun County People's Hospital and Yun County Chinese Medicine Hospital, and 13 township central hospitals) from 1st Jul 2017 to 30th Aug 2020. Patients diagnosed as having a malignant tumor were enrolled and those with abnormal key baseline information were excluded. The epidemiology and disease burden for malignant tumor patients were assessed.

Results: A total of 3,792 patients were enrolled, and the most prevalent cancer in 2018 was thyroid (35.4 patients/100,000) and in 2019 this was lung cancer (30.6 patients/100,000). The mean outpatient visits per person for all-cause and tumor-specific visits were 9.99 and 3.94 visits across 2018 and 2019, respectively, and the mean inpatient visits per person in both years were the same at 2.56 visits. Total costs were 14.471 and 20.29 million in 2018 and 2019, respectively, and 71.7% and 73.0% of the total cost were covered by medical insurance over the 2 years.

Conclusions: The medical environment has improved since medical system reform commenced in 2019 in Yun County, and medical insurance has decreased the disease burden for patients and their families significantly.