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宫颈癌管理中的成本与资源利用:一项真实世界回顾性成本分析

Cost and resource utilization in cervical cancer management: a real-world retrospective cost analysis.

作者信息

Cromwell I, Ferreira Z, Smith L, van der Hoek K, Ogilvie G, Coldman A, Peacock S J

机构信息

Canadian Centre for Applied Research in Cancer Control, Vancouver, BC;; Department of Cancer Control Research, BC Cancer Agency, Vancouver, BC;

Department of Cancer Control Research, BC Cancer Agency, Vancouver, BC;

出版信息

Curr Oncol. 2016 Feb;23(Suppl 1):S14-22. doi: 10.3747/co.23.2914. Epub 2016 Feb 29.

Abstract

OBJECTIVES

We set out to assess the health care resource utilization and cost of cervical cancer from the perspective of a single-payer health care system.

METHODS

Retrospective observational data for women diagnosed with cervical cancer in British Columbia between 2004 and 2009 were analyzed to calculate patient-level resource utilization patterns from diagnosis to death or 5-year discharge. Domains of resource use within the scope of this cost analysis were chemotherapy, radiotherapy, and brachytherapy administered by the BC Cancer Agency; resource utilization related to hospitalization and outpatient visits as recorded by the B.C. Ministry of Health; medically required services billed under the B.C. Medical Services Plan; and prescriptions dispensed under British Columbia's health insurance programs. Unit costs were applied to radiotherapy and brachytherapy, producing per-patient costs.

RESULTS

The mean cost per case of treating cervical cancer in British Columbia was $19,153 (standard error: $3,484). Inpatient hospitalizations, at 35%, represented the largest proportion of the total cost (95% confidence interval: 32.9% to 36.9%). Costs were compared for subgroups of the total cohort.

CONCLUSIONS

As health care systems change the way they manage, screen for, and prevent cervical cancer, cost-effectiveness evaluations of the overall approach will require up-to-date data for resource utilization and costs. We provide information suitable for such a purpose and also identify factors that influence costs.

摘要

目的

我们旨在从单一支付者医疗保健系统的角度评估宫颈癌的医疗资源利用情况和成本。

方法

分析2004年至2009年不列颠哥伦比亚省被诊断为宫颈癌的女性的回顾性观察数据,以计算从诊断到死亡或5年出院的患者层面的资源利用模式。本成本分析范围内的资源使用领域包括不列颠哥伦比亚癌症机构提供的化疗、放疗和近距离放疗;不列颠哥伦比亚省卫生部记录的与住院和门诊就诊相关的资源利用;根据不列颠哥伦比亚省医疗服务计划计费的医疗必需服务;以及根据不列颠哥伦比亚省医疗保险计划配发的处方。将单位成本应用于放疗和近距离放疗,得出每位患者的成本。

结果

不列颠哥伦比亚省治疗宫颈癌的平均每例成本为19,153加元(标准误差:3,484加元)。住院治疗占总成本的比例最大,为35%(95%置信区间:32.9%至36.9%)。对整个队列的亚组成本进行了比较。

结论

随着医疗保健系统改变其管理、筛查和预防宫颈癌的方式,对整体方法的成本效益评估将需要最新的资源利用和成本数据。我们提供了适用于此目的的信息,并确定了影响成本的因素。

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本文引用的文献

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Embracing a new era in cervical cancer screening.拥抱宫颈癌筛查的新时代。
Lancet. 2014 Feb 8;383(9916):493-4. doi: 10.1016/S0140-6736(13)62028-0. Epub 2013 Nov 3.

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