Irving B. Harris Graduate School of Public Policy Studies, University of Chicago, Illinois, USA.
Health Aff (Millwood). 2012 Apr;31(4):667-75. doi: 10.1377/hlthaff.2011.1298.
The United States spends more on health care than other developed countries, but some argue that US patients do not derive sufficient benefit from this extra spending. We studied whether higher US cancer care costs, compared with those of ten European countries, were "worth it" by looking at the survival differences for cancer patients in these countries compared to the relative costs of cancer care. We found that US cancer patients experienced greater survival gains than their European counterparts; even after considering higher US costs, this investment generated $598 billion of additional value for US patients who were diagnosed with cancer between 1983 and 1999. The value of that additional survival gain was highest for prostate cancer patients ($627 billion) and breast cancer patients ($173 billion). These findings do not appear to have been driven solely by earlier diagnosis. Our study suggests that the higher-cost US system of cancer care delivery may be worth it, although further research is required to determine what specific tools or treatments are driving improved cancer survival in the United States.
美国在医疗保健上的支出高于其他发达国家，但有人认为美国患者并没有从这些额外支出中获得足够的收益。我们研究了与十个欧洲国家相比，美国癌症护理费用的增加是否“物有所值”，方法是观察这些国家癌症患者的生存率与癌症护理相对成本之间的差异。我们发现，美国癌症患者的生存率增长高于欧洲患者；即使考虑到美国较高的成本，这一投资为 1983 年至 1999 年间被诊断患有癌症的美国患者带来了 5980 亿美元的额外价值。前列腺癌患者（6270 亿美元）和乳腺癌患者（1730 亿美元）的额外生存获益价值最高。这些发现似乎并非仅仅由早期诊断驱动。我们的研究表明，成本较高的美国癌症护理系统可能是值得的，尽管还需要进一步研究来确定是什么具体的工具或治疗方法在美国推动了癌症生存率的提高。
