{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:05:15Z","timestamp":1789153515356,"version":"build-2803163510"},"reference-count":23,"publisher":"BMJ","issue":"7","funder":[{"name":"the Fundamental Research Funds for the Central Universities of China"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,6,28]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the direct and indirect costs in families with a child with acute lymphoblastic leukaemia (ALL) in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A single-site, cross-sectional survey of primary caregiver of a child with ALL was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>We analysed the total costs incurred on the completion of the first three-phase treatment (induction, consolidation and intensification), which requires intensive hospitalisation. Eligible patients were (1) diagnosed with ALL between 2010 and 2012 at Shanghai Children\u2019s Medical Center (SCMC), (2) aged 0\u201314 years at diagnosis and (3) completed the first three-phase treatment at SCMC. The data were collected between October 2014 and December 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>We decomposed the total costs into three categories: (1) direct medical costs, which were further divided into outpatient and inpatient costs; (2) direct non-medical costs, which referred to expenses incurred in relation to the illness; and (3) indirect costs due to productivity loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 161 patients were included in the study. Direct medical costs accounted for about 51.7% of the overall costs, and the rest of 48.3% of the total costs were attributed to direct non-medical costs and indirect costs. Regarding families with different household registration type (rural vs urban), the total costs were significantly different between the two groups (US\n                      <jats:bold>$<\/jats:bold>\n                      36 125 vs US\n                      <jats:bold>$<\/jats:bold>\n                      25 593; p=0.021). Specifically, urban families incurred significantly larger indirect costs than rural families (US\n                      <jats:bold>$<\/jats:bold>\n                      12 343 vs US\n                      <jats:bold>$<\/jats:bold>\n                      4157; p=0.018). Although the direct non-medical costs were not significantly different, urban families spent more money on hygiene cleaning products and auxiliary treatment equipment (p=0.041) and gifts and treats (p=0.034) than rural families.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The financial burden faced by the Chinese families with a child with ALL was tremendous, and the distributions of costs among the three categories were different between urban and rural families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030511","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T06:26:36Z","timestamp":1563517596000},"page":"e030511","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Direct and indirect costs of families with a child with acute lymphoblastic leukaemia in an academic hospital in China: a cross-sectional survey"],"prefix":"10.1136","volume":"9","author":[{"given":"Yijiong","family":"Ren","sequence":"first","affiliation":[{"name":"Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Social and Public Administration, East China University of Science and Technology, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,7,18]]},"reference":[{"key":"2025120523271074000_9.7.e030511.1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.canlet.2015.04.021","article-title":"Incidence, mortality and survival of childhood cancer in China during 2000\u20132010 period: A population-based study","volume":"363","author":"Zheng","year":"2015","journal-title":"Cancer Lett"},{"key":"2025120523271074000_9.7.e030511.2","first-page":"933","article-title":"The monetary costs of childhood cancer to the families of patients","volume":"8","author":"Barr","year":"1996","journal-title":"Int J Oncol"},{"key":"2025120523271074000_9.7.e030511.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2003.00138.x"},{"key":"2025120523271074000_9.7.e030511.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.2006.00710.x"},{"key":"2025120523271074000_9.7.e030511.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.27.8960"},{"key":"2025120523271074000_9.7.e030511.6","doi-asserted-by":"publisher","DOI":"10.1002\/pon.2009"},{"key":"2025120523271074000_9.7.e030511.7","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2014.001495"},{"issue":"Suppl 5","key":"2025120523271074000_9.7.e030511.8","first-page":"S619","article-title":"Assessment of Financial Burden as a Standard of Care in Pediatric Oncology","volume":"62","author":"Pelletier","year":"2015","journal-title":"Pediatr Blood Cancer"},{"key":"2025120523271074000_9.7.e030511.9","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200311000-00007"},{"key":"2025120523271074000_9.7.e030511.10","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1002\/pbc.24324","article-title":"A mixed method approach to describe the out-of-pocket expenses incurred by families of children with cancer","volume":"60","author":"Tsimicalis","year":"2013","journal-title":"Pediatr Blood Cancer"},{"key":"2025120523271074000_9.7.e030511.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.04.003"},{"key":"2025120523271074000_9.7.e030511.12","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25170"},{"key":"2025120523271074000_9.7.e030511.13","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21448"},{"key":"2025120523271074000_9.7.e030511.14","unstructured":"Report RC . A report on the living conditions of children diagnosed with leukemia in rural China. 2013. Available at https:\/\/wenku.baidu.com\/view\/7004a99b4afe04a1b071dec5.html."},{"key":"2025120523271074000_9.7.e030511.15","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22127"},{"key":"2025120523271074000_9.7.e030511.16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jcpo.2015.10.002","article-title":"Cost of treatment for children with acute lymphoblastic leukemia in Bangladesh","volume":"6","author":"Islam","year":"2015","journal-title":"J Cancer Policy"},{"key":"2025120523271074000_9.7.e030511.17","first-page":"103","article-title":"Financial burden of therapy in families with a child with acute lymphoblastic leukemia: report from north India","volume":"24","author":"Ghatak","year":"2016","journal-title":"Support Care Cancer"},{"key":"2025120523271074000_9.7.e030511.18","first-page":"3703","article-title":"Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China","volume":"25","author":"Wang","year":"2017","journal-title":"Support Care Cancer"},{"key":"2025120523271074000_9.7.e030511.19","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1182\/asheducation-2008.1.374","article-title":"Treatment of acute lymphoblastic leukemia in children and adolescents: peaks and pitfalls","volume":"1","author":"Seibel","year":"2008","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"2025120523271074000_9.7.e030511.20","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-301419"},{"key":"2025120523271074000_9.7.e030511.21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3747\/co.v15i4.260","article-title":"The economic impact on families when a child is diagnosed with cancer","volume":"15","author":"Miedema","year":"2008","journal-title":"Curr Oncol"},{"key":"2025120523271074000_9.7.e030511.22","unstructured":"National Bureau of Statistics of China. Data. 2011. available at http:\/\/www.stats.gov.cn\/tjsj\/ndsj\/2011\/indexch.htm."},{"key":"2025120523271074000_9.7.e030511.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.02.037"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-030511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:27:17Z","timestamp":1765006037000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-030511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":23,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,18]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bmjopen-2019-030511"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-030511","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}