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日本提供正电子发射断层扫描(PET)癌症筛查的医疗设施的效率。

The efficiency of healthcare facilities providing PET cancer screening in Japan.

机构信息

Health Care Economics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

出版信息

Jpn J Radiol. 2012 Apr;30(3):198-205. doi: 10.1007/s11604-011-0032-9. Epub 2011 Dec 23.

Abstract

PURPOSE

The number of positron emission tomography (PET) facilities has rapidly increased in Japan in recent years. We assume there has been a downward spiral that low reimbursement prices for PET scans by public health insurance have driven these facilities to provide cancer screening, leading to a decline in efficiency with more cancer screening. The purpose of this study was to confirm this decline and clarify the determinants of efficiency.

MATERIALS AND METHODS

Questionnaire survey data from 65 facilities that provided PET cancer screening were used. Data envelopment analysis (DEA) was used to measure the efficiency of each facility. Multivariate regression analysis was then performed with each DEA score as a dependent variable, with other potential factors that might affect efficiency as independent variables.

RESULTS

We found that from 2004 to 2006 efficiency in PET facilities declined. However, significantly greater efficiency was observed for those facilities that started cancer screening earlier, were located in an area with an aging population, and were clinics and general hospitals. Conversely, significantly lower efficiency was observed for facilities with higher market share and price for PET cancer screening.

CONCLUSION

Our findings on decreasing efficiency imply that reimbursement prices should be raised to halt the downward spiral.

摘要

目的

近年来,日本正电子发射断层扫描(PET)设备的数量迅速增加。我们假设存在一种恶性循环,即公共医疗保险对 PET 扫描的低报销价格导致这些设施开展癌症筛查,从而导致癌症筛查效率下降。本研究的目的是确认这种下降,并阐明效率的决定因素。

材料与方法

使用了 65 家提供 PET 癌症筛查服务的设施的问卷调查数据。使用数据包络分析(DEA)来衡量每个设施的效率。然后,以每个 DEA 分数作为因变量,以可能影响效率的其他潜在因素作为自变量,进行多元回归分析。

结果

我们发现,2004 年至 2006 年期间,PET 设施的效率下降。然而,对于较早开始癌症筛查、位于人口老龄化地区的诊所和综合医院,效率显著更高。相反,PET 癌症筛查的市场份额和价格较高的设施效率显著较低。

结论

我们关于效率下降的发现表明,应该提高报销价格以阻止这种恶性循环。

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