Expenditure of hospital care on cancer in China, from 2011 to 2015

Objective: A solid understanding of levels and trends of spending on cancer is important to evaluate whether our healthcare resources were wisely spent and to prioritize future resources for cancer treatment and prevention. However, studies on economic burden of cancers in China are scant and the results are inconsistent. Methods: The Chinese hospital information database and nearly 350 million inpatient medical record data were used. As the ratios of cancer inpatient payments to total inpatient payments were mainly influenced by the grades and sites of hospitals, the estimates of payments of cancer inpatients in this study were stratified by hospital grades and provinces. Only the payments of cancer inpatients happened in grade 2, grade 3 and specialized cancer hospitals were included in the analyses. The total medical payments of cancers in China were estimated based on the ratios of outpatient payments to inpatient payments in specialized cancer hospitals. Results: From 2011 to 2015, the payments of cancer inpatients in China have increased by 84.1% and the total inpatient payments reached 177.1 billion RMB in 2015, accounting for 4.3% of the total health expenditure in China. Based on the ratio of outpatient payments to inpatient payments, the total payments on cancer treatments in China were estimated to be 221.4 billion RMB in 2015. Among different cancer types, the highest payments were the treatment of trachea, bronchus and lung cancer. The major cancer inpatient payments (67.1% in 2015) spent in grade 3 general hospitals and this ratio increased continually from 2011 to 2015. The expenditure of cancer treatments also varies by region with the major expenditure in the eastern region of China. Conclusions: This study estimated the total payments of cancer treatments in China and analyzed how the money was spent on cancer treatments in the recent 5 years, which would provide information for decision makings on the allocation of resources to service provisioning, prevention strategies, research funding, and assessing whether the economic burden of cancer is affordable to the governments.

Chidamide-BEAC plus autologous stem cell transplantation in high-risk non-Hodgkin lymphoma:a phase II clinical trial

To the Editor:Non-Hodgkin lymphoma(NHL)is a common type of hematological malignancy.Although the development of targeted therapies has improved the survival of patients with aggressive NHL,autologous hematopoietic stem cell transplantation(HSCT)remains indispensable.There is no standard conditioning regimen for autologous stem cell transplantation(ASCT).

Estimation of daily PM2.5 concentration and its relationship with meteorological conditions in Beijing

When investigating the impact of air pollution on health, particulate matter less than 2.5μm in aerodynamic diameter （PM2.5） is considered more harrnful than particulates of other sizes. Therefore, studies of PM2.5 have attracted more attention. Beijing, the capital of China, is notorious for its serious air pollution problem, an issue which has been of great concern to the residents, government, and related institutes for decades. However, in China, significantly less time has been devoted to observing PM2.5 than for PM10. Especially before 2013, the density of the PM2.5 ground observation network was relatively low, and the distribution of observation stations was uneven. One solution is to estimate PM2.5 concentrations from the existing data on PM10. In the present study, by analyzing the relationship between the concentrations of PM2.5 and PM10, and the meteorological conditions for each season in Beijing from 2008 to 2014, a U-shaped relationship was found between the daily maximum wind speed and the daily PM concentration, including both PM2.5 and PM10. That is, the relationship between wind speed and PM concentration is not a simple positive or negative correlation in these wind directions; their relationship has a complex effect, with higher PM at low and high wind than for moderate winds. Additionally, in contrast to previous studies, we found that the PM2.5/PM10 ratio is proportional to the mean relative humidity （MRH）. According to this relationship, for each season we established a multiple nonlinear regression （MNLR） model to estimate the PM2.5 concentrations of the missing periods.