Medical Cost of Cancer Care for Privately Insured Children in Chile

Abstract

Medical care for children with cancer is complex and expensive, and represents a large financial burden for families around the world. We estimated the medical cost of cancer care for children under the age of 18, using administrative records of the universe of children with private insurance in Chile in the period 2007-2018, based on a sample of 3853 observations. We analyzed total cost and out-of-pocket spending by patients' characteristics, type of cancer, and by service. Children with cancer had high annual medical costs, USD 32,287 on average for 2018. Costs were higher for the younger children in the sample. The vast majority of the cost was driven by inpatient hospital care for all types of cancer. The average total cost increased 20% in real terms over the period of study, while out-of-pocket expenses increased almost 29%. Private insurance beneficiaries faced a significant economic burden associated with medical treatment of a child with cancer. Interventions that reduce hospitalizations, as well as systemwide reforms that incorporate maximum out-of-pocket payments and prevent catastrophic expenditures, can contribute to alleviating the financial burden of childhood cancer.

Keywords: administrative data; childhood cancer; medical cost.

Figure 1

Average annual total costs and out-of-pocket payments, by year. Children with cancer, 2007 to 2018. Private health insurance system.

Figure 2

Inpatient and outpatient total costs and out-of-pocket payments. Children with cancer, 2007 to 2018. Private health insurance system. (a) Average total costs; (b) average out-of-pocket payments. For each year, inpatient and outpatient costs add up to total cost.

Figure 3

Inpatient and outpatient average annual and out-of-pocket costs, by type of cancer, 2007 to 2018. Private health insurance system. (a) Average total costs; (b) average out-of-pocket payments. For each year, inpatient and outpatient costs add up to total cost.