Demeter Sandor J, Jacobs Philip, Chmielowiec Chester, Logus Wayne, Hailey David, Fassbender Konrad, McEwan Alexander
Department of Radiology and Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Can Respir J. 2007 Mar;14(2):81-6. doi: 10.1155/2007/847604.
Lung cancer is the leading cause of cancer morbidity and mortality. In addition, lung cancer has a significant economic impact on society.
To present an economic analysis of the actual care costs of lung cancer which will allow comparison with, and verification of, cost estimates that were developed through modelling and opinion.
A chart review was conducted of incident cases (circa 1998) of primary bronchogenic lung cancer. Cases were censored at two years from the date of diagnosis. Relevant clinical and health utilization data were collected. Health utilization data included hospital and institutional outpatient (ie, ambulatory clinic) costs. Cost estimates were derived for over 200 specific health services. The present analysis was performed from the economic perspective of the health care institution.
A total of 13,389 health service events were captured with an estimated total cost of $8.4 million. Laboratory tests, diagnostic imaging and ambulatory visits constituted 86% of the service events while patient admissions and therapy constituted 76% of the costs. The vast majority of overall costs occurred just before, or within, three months of diagnosis. The median nonsmall cell lung cancer and small cell lung cancer case costs were $10,928 (range $9,234 to $11,047) and $15,350 (range $13,033 to $21,436), respectively.
The results agree with the literature that the majority of lung cancer case costs are realized around the date of diagnosis (ie, early phase). The present study illustrates Canadian health care system lung cancer case costs based on actual care received versus hypothetical care algorithms.
肺癌是癌症发病和死亡的主要原因。此外,肺癌对社会有重大经济影响。
对肺癌实际治疗成本进行经济分析,以便与通过建模和专家意见得出的成本估算进行比较和验证。
对原发性支气管肺癌的发病病例(约1998年)进行病历回顾。从诊断日期起两年对病例进行审查。收集相关临床和医疗利用数据。医疗利用数据包括医院和机构门诊(即门诊诊所)费用。得出了200多种特定医疗服务的成本估算。本分析是从医疗机构的经济角度进行的。
共记录了13389次医疗服务事件,估计总成本为840万美元。实验室检查、诊断成像和门诊就诊占服务事件的86%,而患者住院和治疗占成本的76%。绝大多数总成本发生在诊断前或诊断后三个月内。非小细胞肺癌和小细胞肺癌病例的中位成本分别为10928美元(范围为9234美元至11047美元)和15350美元(范围为13033美元至21436美元)。
结果与文献一致,即大多数肺癌病例成本在诊断日期左右(即早期阶段)产生。本研究说明了加拿大医疗保健系统中基于实际接受的治疗与假设治疗算法的肺癌病例成本。