Will B P, Berthelot J M, Nobrega K M, Flanagan W, Evans W K
The Health Analysis and Modeling Group, Statistics Canada, 24-Q, R. H. Coats Building, ON, K1A OT6, Ottawa, Canada.
Eur J Cancer. 2001 Sep;37(14):1797-804. doi: 10.1016/s0959-8049(01)00204-0.
This paper describes the Population Health Model (POHEM) developed by Statistics Canada and shows its usefulness in the evaluation of cancer control interventions and policy decision-making. Models of the costs of diagnosis and treatment of lung and breast cancer were developed and incorporated into POHEM. Then, POHEM was used to evaluate the economic impact of chemotherapy for advanced non-small cell lung cancer; reduced length of hospital stay following breast cancer surgery; and the provision of preventive tamoxifen to women at high risk of breast cancer. A lung cancer chemotherapy treatment decision framework was developed to rank order currently available chemotherapy regimens according to relative cost-effectiveness and cost-utility. Reducing post-surgical breast cancer hospitalisation with optimal home care support could produce major healthcare savings. However, the provision of preventive tamoxifen was estimated to have no population health benefit. This paper demonstrates that POHEM is an effective tool for performing economic evaluations of cancer control interventions and to inform healthcare policy decisions.
本文介绍了加拿大统计局开发的人口健康模型（POHEM），并展示了其在癌症控制干预措施评估和政策决策中的有用性。开发了肺癌和乳腺癌诊断与治疗成本模型，并将其纳入POHEM。然后，POHEM被用于评估晚期非小细胞肺癌化疗的经济影响；乳腺癌手术后住院时间的缩短；以及为乳腺癌高危女性提供预防性他莫昔芬的情况。开发了一个肺癌化疗治疗决策框架，以根据相对成本效益和成本效用对目前可用的化疗方案进行排序。通过最佳的家庭护理支持减少乳腺癌手术后的住院时间可以节省大量医疗费用。然而，据估计，提供预防性他莫昔芬对人群健康没有益处。本文表明，POHEM是进行癌症控制干预措施经济评估和为医疗政策决策提供信息的有效工具。
