|
2017年7月3日，澳大利亚《亚太临床肿瘤杂志》在线发表湖南省肿瘤医院、中国医学科学院肿瘤医院、国家癌症中心、郑州大学附属肿瘤医院、河南省肿瘤医院、兰州大学、哈尔滨医科大学、中国医学科学院医学信息研究所、山东大学、甘肃省肿瘤医院、哈尔滨医科大学附属肿瘤医院、山东省肿瘤医院、江苏省疾病预防控制中心、浙江省肿瘤医院、重庆市肿瘤医院、广东省公共卫生研究院、新疆医科大学附属肿瘤医院、铁岭市中心医院、徐州市疾病预防控制中心、哈尔滨市疾病预防控制中心、宁波市第二医院、唐山市人民医院、开滦总医院的中国城市癌症早诊早治项目（CanSPUC）卫生经济学评价工作组多中心横断面研究报告，评定了中国乳腺癌诊治的经济负担，并为决策提供理论依据。 该研究于2012年9月～2014年12月在中国13个省份37个医院中心进行调查，收集患者特征信息，然后评定乳腺癌诊治的医疗和非医疗（包括交通、住宿、饮食、营养、陪护）支出、影响平均每例费用的因素、不同临床分期的医疗支出和非医疗支出差异、新确诊病例报销后总支出对患者家庭的经济影响、患者及其家庭非医疗支出和时间损失的构成。 结果发现：
因此，由于成本随着恶性程度增加而上升，故乳腺癌的早期发现和治疗可能有效减少经济负担。 Asia Pac J Clin Oncol. 2017 Jul 3. [Epub ahead of print] Medical and non-medical expenditure for breast cancer diagnosis and treatment in China: a multicenter cross-sectional study. Liao XZ, Shi JF, Liu JS, Huang HY, Guo LW, Zhu XY, Xiao HF, Wang L, Bai YN, Liu GX, Mao AY, Ren JS, Sun XJ, Mai L, Liu YQ, Song BB, Gong JY, Zhou JY, Du LB, Zhou Q, Cao R, Zhu L, Ren Y, Lou PA, Lan L, Sun XH, Qi X, Wang YZ, Zhang K, He J, Dai M; Health Economic Evaluation Working Group, Cancer Screening Program in Urban China (CanSPUC). Hunan Cancer Hospital, Changsha, China; National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China; Lanzhou University, Lanzhou, China; Harbin Medical University, Harbin, China; Institute of Medical Information, CAMS, Beijing, China; Shandong University, Jinan, China; Gansu Provincial Cancer Hospital, Lanzhou, China; Affiliated Cancer Hospital of Harbin Medical University, Harbin, China; Shandong Tumor Hospital, Jinan, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; Zhejiang Cancer Hospital, Hangzhou, China; Chongqing Cancer Hospital, Chongqing, China; Guangdong Provincial Institute of Public Health, Guangzhou, China; Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China; Tieling Central Hospital, Tieling, China; Xuzhou Center for Disease Control and Prevention, Xuzhou, China; Harbin Center for Disease Control and Prevention, Harbin, China; Ningbo No.2 Hospital, Ningbo, China; Tangshan People's Hospital, Tangshan, China; Kailuan General Hospital, Tangshan, China. AIM: We aimed to assess economic burden of breast cancer diagnosis and treatment in China through a multicenter cross-sectional study, and to obtain theoretical evidence for policy-making. METHODS: This survey was conducted in 37 hospital centers across 13 provinces in China from September 2012 to December 2014. We collected information on the subject characteristics. We then assessed the medical and non-medical expenditure for breast cancer diagnosis and treatment, factors influencing the average case expense, variations between medical and non-medical expenditure at different clinical stages, economic impact of overall expenditure in newly diagnosed course after reimbursement to the patient's family, composition of non-medical expenditure and time loss for the patient and family. RESULTS: Among 2746 women with breast cancer (72.6% were admitted to specialized hospitals), the overall average expenditure was US $8450 (medical expenditure: $7527; non-medical expenditure: $922). Significant differences were found among the overall expenditure in the four clinical stages (P < 0.0001); the expenditure was higher in stages III and IV than that in stages I and II, whereas the stage IV was the highest (P < 0.0001). Moreover, a higher self-reported predicted reimbursement ratio was associated with a less economic impact on the patient's family, and the average time lost was estimated as $1529. CONCLUSIONS: Early detection and treatment of breast cancer might be effective for decreasing the economic burden, because costs escalate as the degree of malignancy increases. KEYWORDS: breast cancer; medical expenditure; multicenter; non-medical expenditure PMID: 28670694 DOI: 10.1111/ajco.12703
|
|
|
