Russell Heidi, Bernhardt M Brooke
Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, 6701 Fannin St, Suite 1580.00, Houston, TX, 77030, USA.
Department of Pharmacy, Texas Children's Hospital, 6621 Fannin St, WB1-120, Houston, TX, 77030, USA.
Curr Hematol Malig Rep. 2016 Aug;11(4):295-302. doi: 10.1007/s11899-016-0332-3.
Healthcare for children with cancer costs significantly more than other children. Cost reduction efforts aimed toward relatively small populations of patients that use a disproportionate amount of care, like childhood cancer, could have a dramatic impact on healthcare spending. The aims of this review are to provide stakeholders with an overview of the drivers of financial costs of childhood cancer and to identify possible directions to curb or decrease these costs. Costs are incurred throughout the spectrum of care. Recent trends in pharmaceutical costs, evidence identifying the contribution of administration costs, and overuse of surveillance studies are described. Awareness of cost and value, i.e., the outcome achieved per dollar or burden spent, in delivery of care and research is necessary to bend the cost curve. Incorporation of these dimensions of care requires methodology development, prioritization, and ethical balance.
癌症患儿的医疗保健费用比其他儿童要高得多。针对使用了不成比例的医疗资源的相对少数患者群体（如儿童癌症患者）开展的成本降低措施，可能会对医疗保健支出产生巨大影响。本综述的目的是向利益相关者概述儿童癌症财务成本的驱动因素，并确定控制或降低这些成本的可能方向。在整个护理过程中都会产生成本。文中描述了药品成本的近期趋势、确定管理成本贡献的证据以及监测研究的过度使用情况。在提供护理和开展研究时，了解成本和价值（即每花费一美元所取得的结果或负担）对于扭转成本曲线是必要的。将护理的这些方面纳入考量需要方法学的发展、优先排序以及伦理平衡。
