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影响英国肺癌患者住院费用的因素。

Factors affecting hospital costs in lung cancer patients in the United Kingdom.

作者信息

Kennedy Martyn P T, Hall Peter S, Callister Matthew E J

机构信息

Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.

Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Crewe Road South, EH4 2XR, UK.

出版信息

Lung Cancer. 2016 Jul;97:8-14. doi: 10.1016/j.lungcan.2016.04.009. Epub 2016 Apr 14.

Abstract

INTRODUCTION

Rising healthcare costs and financial constraints are increasing pressure on healthcare budgets. There is little published data on the healthcare costs of lung cancer in the UK, with international studies mostly small and limited by data collection methods. Accurate assessment of healthcare costs is essential for effective service planning.

METHODS

We conducted a retrospective, descriptive cohort study linking clinical data from a local electronic database of lung cancer patients at a large UK teaching hospital with recorded hospital income. Costs were adjusted to 2013-2014 prices.

RESULTS

The study analysed secondary care costs of 3274 patients. Mean cumulative costs were £5852 (95% CI, £5694 to £6027) at 90 days and £10,009 (95% CI, £9717 to £10,278) at one year. The majority of costs (58.5%) were accumulated within the first 90 days, with acute inpatient costs the largest contributor at one year (42.1%). The strongest predictor of costs was active treatment, especially surgery. Costs were also affected by age, route to diagnosis, clinical stage and cell type.

DISCUSSION

Successful early diagnosis initiatives that increase radical treatment rates and improve outcomes may significantly increase the secondary care costs of lung cancer management. The use of routine NHS clinical and financial data can enable efficient and effective analyses of large cohort health economic data.

摘要

引言

不断上涨的医疗成本和财务限制给医疗预算带来了越来越大的压力。关于英国肺癌医疗成本的公开数据很少,国际研究大多规模较小且受数据收集方法的限制。准确评估医疗成本对于有效的服务规划至关重要。

方法

我们进行了一项回顾性描述性队列研究,将英国一家大型教学医院当地肺癌患者电子数据库中的临床数据与记录的医院收入相联系。成本已按2013 - 2014年价格进行调整。

结果

该研究分析了3274名患者的二级医疗成本。90天时的平均累积成本为5852英镑(95%置信区间,5694英镑至6027英镑),一年时为10,009英镑(95%置信区间,9717英镑至10,278英镑)。大部分成本(58.5%)在最初90天内累积,急性住院成本是一年中最大的成本贡献者(42.1%)。成本的最强预测因素是积极治疗,尤其是手术。成本还受年龄、诊断途径、临床分期和细胞类型的影响。

讨论

成功的早期诊断举措提高了根治性治疗率并改善了治疗效果,但可能会显著增加肺癌管理的二级医疗成本。利用国民保健服务(NHS)常规临床和财务数据能够对大型队列健康经济数据进行高效且有效的分析。

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