Maroun Jean, Ng Edward, Berthelot Jean-Marie, Le Petit Christel, Dahrouge Simone, Flanagan William M, Walker Hugh, Evans William K
Ottawa Regional Cancer Centre, 503 Smyth Road, Ottawa, Ontario, Canada K1H 1C4.
Chronic Dis Can. 2003 Fall;24(4):91-101.
Colorectal cancer is the second leading cause of cancer-related mortality among Canadians. We derived the direct health care costs associated with the lifetime management of an estimated 16,856 patients with a diagnosis of colon and rectal cancer in Canada in 2000. Information on diagnostic approaches, treatment algorithms, follow-up and care at disease progression was obtained from various databases and was integrated into Statistics Canada's Population Health Model (POHEM) to estimate lifetime costs. The average lifetime cost (in Canadian dollars) of managing patients with colorectal cancer ranged from $20,319 per case for TNM stage I colon cancer to $39,182 per case for stage III rectal cancer. The total lifetime treatment cost for the cohort of patients in 2000 was estimated to be over $333 million for colon and $187 million for rectal cancer. Hospitalization represented 65% and 61% of the lifetime costs of colon and rectal cancer respectively. Disease costing models can be important policy- relevant tools to assist in resource allocation. Our results highlight the importance of performing preoperative tests and staging in an ambulatory care setting, where possible, to achieve optimal cost efficiencies. Similarly, terminal care might be delivered more efficiently in the home environment or in palliative care units.
结直肠癌是加拿大癌症相关死亡的第二大主要原因。我们推算出了2000年加拿大约16,856例诊断为结肠癌和直肠癌患者终生管理的直接医疗费用。从各种数据库获取了有关诊断方法、治疗方案、随访以及疾病进展时的护理等信息，并将其整合到加拿大统计局的人口健康模型（POHEM）中以估算终生费用。管理结直肠癌患者的平均终生费用（以加元计）从TNM I期结肠癌每例20,319加元到III期直肠癌每例39,182加元不等。2000年该队列患者的终生治疗总费用估计结肠癌超过3.33亿加元，直肠癌为1.87亿加元。住院费用分别占结肠癌和直肠癌终生费用的65%和61%。疾病成本核算模型可能是有助于资源分配的重要政策相关工具。我们的结果凸显了尽可能在门诊环境中进行术前检查和分期以实现最佳成本效益的重要性。同样，终末期护理在家庭环境或姑息治疗病房中可能会更有效地提供。
