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 Background The increasing hospitalization expenses for Gastric Cancer (GC) impose a notable economic burden on society. Although the Chinese government has implemented the Universal Zero Markup Drug Policy (UZMDP) to control the growth of hospitalization expenditures, costs have continued t...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-025-12422-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850172887592337408 |
|---|---|
| author | Yichun Gu Jiajun Hao Da He Hui Sun Xin Cui Wenqi Tian Yulin Zhang Chunlin Jin Haiyin Wang |
| author_facet | Yichun Gu Jiajun Hao Da He Hui Sun Xin Cui Wenqi Tian Yulin Zhang Chunlin Jin Haiyin Wang |
| author_sort | Yichun Gu |
| collection | DOAJ |
| description | Abstract Background The increasing hospitalization expenses for Gastric Cancer (GC) impose a notable economic burden on society. Although the Chinese government has implemented the Universal Zero Markup Drug Policy (UZMDP) to control the growth of hospitalization expenditures, costs have continued to rise. Identifying the factors influencing the hospitalization expenses of GC patients is crucial. This study aimed to analyze the trends and factors influencing hospitalization expenses of GC patients in Shanghai from 2014 to 2021. Methods 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 the UZMDP. The degree of association between various medical expenditures and hospitalization expenditures of GC patients was calculated by using the new grey relational analysis (GRA). Furthermore, multiple linear regression was employed to identify the influencing factors. Results A total of 23,335 participants were included in this study. The ITSA results showed an increasing trend in hospitalization expenses following the implementation of UZMDP. Drug expenses decreased immediately post-UZMDP, but subsequently began to rise over time. Post-UZMDP, the expenses of medical consumables, examination, and healthcare services all showed an upward trend. The new GRA indicated that the influencing factors of hospitalization expenses, in order of importance, were expenses for drugs, consumables, healthcare services, and examination. Multivariable linear regression analysis revealed that GC patients aged 60 or below incurred lower hospitalization expenses (Coefficient = -780.06, P = 0.0398). However, factors associated with increased hospitalization expenses included longer length of stay (Coefficient = 1753.01, P < 0.001), surgeries (Coefficient = 29,047.26, P < 0.001), and hospitalization in the tertiary hospitals (Coefficient = 25,485.19, P < 0.001) or secondary hospitals (Coefficient = 17,755.12, 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, 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 basis for more effective management of the hospitalization expenses for GC patients. |
| format | Article |
| id | doaj-art-92fa29d6db0e4a66bcf33f7421867bda |
| institution | OA Journals |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-92fa29d6db0e4a66bcf33f7421867bda2025-08-20T02:19:58ZengBMCBMC Health Services Research1472-69632025-04-0125111010.1186/s12913-025-12422-4The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021Yichun Gu0Jiajun Hao1Da He2Hui Sun3Xin Cui4Wenqi Tian5Yulin Zhang6Chunlin Jin7Haiyin Wang8Shanghai Health Development Research CenterSchool of Public Health, Zhejiang University School of MedicineShanghai Health Development Research CenterShanghai Health Development Research CenterShanghai Health Statistics CenterShanghai Health Statistics CenterSchool of International Pharmaceutical Business, China Pharmaceutical UniversityShanghai Health Development Research CenterShanghai Health Development Research CenterAbstract Background The increasing hospitalization expenses for Gastric Cancer (GC) impose a notable economic burden on society. Although the Chinese government has implemented the Universal Zero Markup Drug Policy (UZMDP) to control the growth of hospitalization expenditures, costs have continued to rise. Identifying the factors influencing the hospitalization expenses of GC patients is crucial. This study aimed to analyze the trends and factors influencing hospitalization expenses of GC patients in Shanghai from 2014 to 2021. Methods 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 the UZMDP. The degree of association between various medical expenditures and hospitalization expenditures of GC patients was calculated by using the new grey relational analysis (GRA). Furthermore, multiple linear regression was employed to identify the influencing factors. Results A total of 23,335 participants were included in this study. The ITSA results showed an increasing trend in hospitalization expenses following the implementation of UZMDP. Drug expenses decreased immediately post-UZMDP, but subsequently began to rise over time. Post-UZMDP, the expenses of medical consumables, examination, and healthcare services all showed an upward trend. The new GRA indicated that the influencing factors of hospitalization expenses, in order of importance, were expenses for drugs, consumables, healthcare services, and examination. Multivariable linear regression analysis revealed that GC patients aged 60 or below incurred lower hospitalization expenses (Coefficient = -780.06, P = 0.0398). However, factors associated with increased hospitalization expenses included longer length of stay (Coefficient = 1753.01, P < 0.001), surgeries (Coefficient = 29,047.26, P < 0.001), and hospitalization in the tertiary hospitals (Coefficient = 25,485.19, P < 0.001) or secondary hospitals (Coefficient = 17,755.12, 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, 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 basis for more effective management of the hospitalization expenses for GC patients.https://doi.org/10.1186/s12913-025-12422-4Gastric cancerUniversal zero markup drug policyExpensesHospitalizationInterrupted time series analysisNew grey relational analysis |
| spellingShingle | Yichun Gu Jiajun Hao Da He Hui Sun Xin Cui Wenqi Tian Yulin Zhang Chunlin Jin Haiyin Wang The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 BMC Health Services Research Gastric cancer Universal zero markup drug policy Expenses Hospitalization Interrupted time series analysis New grey relational analysis |
| title | The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 |
| title_full | The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 |
| title_fullStr | The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 |
| title_full_unstemmed | The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 |
| title_short | The universal zero markup drug policy and gastric cancer hospitalization expenses: an analysis of trends and influencing factors in Shanghai from 2014 to 2021 |
| title_sort | universal zero markup drug policy and gastric cancer hospitalization expenses an analysis of trends and influencing factors in shanghai from 2014 to 2021 |
| topic | Gastric cancer Universal zero markup drug policy Expenses Hospitalization Interrupted time series analysis New grey relational analysis |
| url | https://doi.org/10.1186/s12913-025-12422-4 |
| work_keys_str_mv | AT yichungu theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT jiajunhao theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT dahe theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT huisun theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT xincui theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT wenqitian theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT yulinzhang theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT chunlinjin theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT haiyinwang theuniversalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT yichungu universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT jiajunhao universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT dahe universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT huisun universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT xincui universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT wenqitian universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT yulinzhang universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT chunlinjin universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 AT haiyinwang universalzeromarkupdrugpolicyandgastriccancerhospitalizationexpensesananalysisoftrendsandinfluencingfactorsinshanghaifrom2014to2021 |