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美国的癌症治疗费用:负担是否随时间推移而转移?

Cancer treatment cost in the United States: has the burden shifted over time?

机构信息

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.

出版信息

Cancer. 2010 Jul 15;116(14):3477-84. doi: 10.1002/cncr.25150.

Abstract

BACKGROUND

There has not been a comprehensive analysis of how aggregate cancer costs have changed over time. The authors present 1) updated estimates of the prevalence and total cost of cancer for select payers and how these have changed over the past 2 decades; and 2) for each payer, the distribution of payments by type of service over time to assess whether there have been shifts in cancer treatment settings.

METHODS

Pooled data from the 2001 through 2005 Medical Expenditure Panel Survey and the 1987 National Medical Care Expenditure Survey were used for the analysis. The authors used an econometric approach to estimate cancer-attributable medical expenditures by payer and type of service.

RESULTS

In 1987, the total medical cost of cancer (in 2007 US dollars) was $24.7 billion. Private payers financed the largest share of the total (42%), followed by Medicare (33%), out of pocket (17%), other public (7%), and Medicaid (1%). Between 1987 and the 2001 to 2005 period, the total medical cost of cancer increased to $48.1 billion. In 2001 to 2005, the shares of cancer costs were: private insurance (50%), Medicare (34%), out of pocket (8%), other public (5%), and Medicaid (3%). The share of total cancer costs that resulted from inpatient admissions fell from 64.4% in 1987 to 27.5% in 2001 to 2005.

CONCLUSIONS

The authors identified 3 trends in the total costs of cancer: 1) the medical costs of cancer have nearly doubled; 2) cancer costs have shifted away from the inpatient setting; and 3) the share of these costs paid for by private insurance and Medicaid have increased.

摘要

背景

目前尚未对癌症总费用随时间变化的情况进行全面分析。本文作者呈现了 1)特定支付方的癌症流行率和总费用的最新估计值及其在过去 20 年中的变化情况;2)对于每个支付方,随时间推移按服务类型划分的支付款项分布情况,以评估癌症治疗环境是否发生了转变。

方法

利用 2001 年至 2005 年医疗支出调查和 1987 年国家医疗支出调查的汇总数据进行分析。作者采用计量经济学方法,按支付方和服务类型估计癌症相关医疗支出。

结果

1987 年,癌症的总医疗费用(按 2007 年美元计算)为 247 亿美元。私人支付方负担了总费用的最大份额(42%),其次是医疗保险(33%)、自付费用(17%)、其他公共保险(7%)和医疗补助(1%)。1987 年至 2001 年至 2005 年期间,癌症的总医疗费用增至 481 亿美元。2001 年至 2005 年,癌症费用的份额为:私人保险(50%)、医疗保险(34%)、自付费用(8%)、其他公共保险(5%)和医疗补助(3%)。1987 年住院治疗占癌症总费用的 64.4%,2001 年至 2005 年降至 27.5%。

结论

作者发现癌症总费用有 3 个趋势:1)癌症医疗费用几乎翻了一番;2)癌症费用已从住院环境转移;3)私人保险和医疗补助支付的这些费用的份额有所增加。

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