基于人群的乳腺癌家庭护理服务：利用与成本。
Population-based home care services in breast cancer: utilization and costs.
机构信息
Health Outcomes and PharmacoEconomic ( hope ) Research Centre, Sunnybrook Health Sciences Centre, Toronto, ON. ; Department of Pharmacology, University of Toronto, Toronto, ON. ; International Centre for Health Innovation ( ichi ), Richard Ivey School of Business, Western University, London, ON.
出版信息
Curr Oncol. 2012 Dec;19(6):e383-91. doi: 10.3747/co.19.1078.
OBJECTIVE
To determine utilization and costs of home care services (hcs) for individuals with a diagnosis of breast cancer (bc).
METHODS
Incident cases of invasive bc in women were extracted from the Ontario Cancer Registry (2005-2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of hcs used were determined and stratified by disease stage. Attributable home care utilization and costs for bc patients were determined. Factors associated with hcs costs were assessed using regression analysis.
RESULTS
Among the 39,656 bc and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of bc patients used hcs (62.1% stage i; 85.7% stage ii; 94.6% stage iii; 79.1% stage iv) compared with 14.6% of control patients. The number of hcs used per patient-year were significantly higher for the bc patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient-year ($1,210 vs. $325; $885 attributable cost to bc, p < 0.01). The number of hcs utilized and the associated costs increased as the bc stage increased. In contrast, hcs costs decreased as income increased and as previous health care exposure decreased.
INTERPRETATION
Patients with bc used twice as many hcs, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per bc patient per year were spent on hcs utilization in the study population.
目的
确定诊断为乳腺癌（bc）的个体的家庭护理服务（hcs）的利用情况和费用。
方法
从安大略省癌症登记处（2005-2009 年）提取女性浸润性 bc 的发病病例，并与其他安大略省卫生保健管理数据库进行链接。对照患者从从未被诊断出任何类型癌症的女性人群中选择。确定并按疾病阶段分层了使用的 hcs 类型和比例。确定了 bc 患者归因于 hcs 的利用和费用。使用回归分析评估与 hcs 费用相关的因素。
结果
在所确定的 39656 名 bc 患者和 198280 名对照患者中（中位年龄：bc 患者为 61.6 岁，对照患者为 61.6 岁），75.4%的 bc 患者使用了 hcs（i 期 62.1%；ii 期 85.7%；iii 期 94.6%；iv 期 79.1%），而对照患者中仅为 14.6%。与对照患者相比，bc 患者每位患者每年使用的 hcs 数量明显更高（14.97 比 6.13，p <0.01），导致每位患者每年的费用更高（1210 比 325；归因于 bc 的 885 美元，p <0.01）。随着 bc 分期的增加，hcs 的利用数量和相关费用增加。相反，随着收入的增加和先前的医疗保健暴露的减少，hcs 成本降低。
解释
bc 患者使用的 hcs 数量是对照组的两倍，导致费用几乎是对照组的 4 倍。在研究人群中，每位 bc 患者每年用于 hcs 利用的费用不到 1000 美元。
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