Schraub S, Mougeot M, Mercier M, Bourgeois P
Cancer Registry of Doubs, Hôpital Jean Minjoz, Besançon, France.
Health Policy. 1991 Aug;18(3):219-29. doi: 10.1016/0168-8510(91)90023-q.
It is currently estimated in France, that the cost of cancer has risen to $3.8 billion, with an annual growth of 5-10%. This represents approximately 6% of all health expenditure. The data from the Registry of Tumors in the Doubs region have enabled us to make an evaluation of health expenditure, reimbursed by the French Securite Sociale (S.S.), and its distribution in relation to different activities (diagnosis, type of treatment, follow-up, transport), according to cancer site. In 1984, the average cost per patient within the first 6 months of the illness was evaluated at $4,000. The results show major differences for the cancer sites, care facilities and budget items. Diagnosis assessment represents 27% of all expenditure, surgery 37%, radiotherapy, chemotherapy and transport, 11% each. All kinds of expenses are fully reimbursed by the French S.S. and transportation, which at the beginning used to avoid hospitalization, is now used as a comfort system and represents a high cost to the S.S. The different costs for the same illness between private, general public and university hospitals do not reflect a difference in care, but rather different systems of calculating and functioning. Till now there has not been any logical evaluation of care in the French health system.
目前在法国估计,癌症治疗费用已升至38亿美元,且每年以5%至10%的速度增长。这约占所有医疗支出的6%。杜省肿瘤登记处的数据使我们能够评估法国社会保障局(S.S.)报销的医疗支出,以及根据癌症部位,其在不同活动(诊断、治疗类型、随访、交通)中的分布情况。1984年,患者患病头6个月的平均费用评估为4000美元。结果显示,癌症部位、护理设施和预算项目存在重大差异。诊断评估占所有支出的27%,手术占37%,放疗、化疗和交通各占11%。法国社会保障局全额报销各类费用,交通费用起初是为了避免住院,现在则用作一种舒适服务体系,这对社会保障局来说成本很高。私立医院、公立医院和大学医院治疗同一种疾病的不同费用并没有反映出护理上的差异,而是反映了不同的计算和运作体系。到目前为止,法国医疗体系中尚未对护理进行任何合理评估。