Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China

Abstract Background 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...

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Main Authors: Jun Su, Yu-qing Zhang, Di Shao, Jia-min Wang, Wei Hao, Yan-xiu Liu, Long Wang, Xiao-jie Sun
Format: Article
Language:English
Published: BMC 2025-03-01
Series:International Journal for Equity in Health
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Online Access:https://doi.org/10.1186/s12939-025-02442-1
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author Jun Su
Yu-qing Zhang
Di Shao
Jia-min Wang
Wei Hao
Yan-xiu Liu
Long Wang
Xiao-jie Sun
author_facet Jun Su
Yu-qing Zhang
Di Shao
Jia-min Wang
Wei Hao
Yan-xiu Liu
Long Wang
Xiao-jie Sun
author_sort Jun Su
collection DOAJ
description Abstract Background 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. Methods 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. Results 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). Conclusion 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.
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spelling doaj-art-9826f1eeb69b4d389ffcf08effa849fd2025-08-20T02:51:27ZengBMCInternational Journal for Equity in Health1475-92762025-03-012411910.1186/s12939-025-02442-1Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in ChinaJun Su0Yu-qing Zhang1Di Shao2Jia-min Wang3Wei Hao4Yan-xiu Liu5Long Wang6Xiao-jie Sun7Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong UniversityAbstract Background 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. Methods 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. Results 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). Conclusion 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.https://doi.org/10.1186/s12939-025-02442-1Pediatric leukemiaCatastrophic health expenditureCharitable medical assistanceHealthcare security
spellingShingle Jun Su
Yu-qing Zhang
Di Shao
Jia-min Wang
Wei Hao
Yan-xiu Liu
Long Wang
Xiao-jie Sun
Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
International Journal for Equity in Health
Pediatric leukemia
Catastrophic health expenditure
Charitable medical assistance
Healthcare security
title Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
title_full Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
title_fullStr Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
title_full_unstemmed Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
title_short Does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia? An evidence-based study in China
title_sort does the charitable medical assistance program impact catastrophic medical expenditures for families of children with leukemia an evidence based study in china
topic Pediatric leukemia
Catastrophic health expenditure
Charitable medical assistance
Healthcare security
url https://doi.org/10.1186/s12939-025-02442-1
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