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非正式护理的经济估值及决定因素随时间的差异:以血癌为例

Differences in the economic valuation and determining factors of informal care over time: the case of blood cancer.

作者信息

Ortega-Ortega Marta, Montero-Granados Roberto, Jiménez-Aguilera Juan de Dios

机构信息

Applied Economic Department, School of Economic and Business, University of Granada, Granada, Spain.

Applied Economic Department, School of Economic and Business, University of Granada, Granada, Spain.

出版信息

Gac Sanit. 2018 Sep-Oct;32(5):411-417. doi: 10.1016/j.gaceta.2017.02.006. Epub 2017 May 19.

Abstract

OBJECTIVE

To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients.

METHODS

139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant). Economic value of informal care was estimated using proxy good and opportunity cost methods. Ordered and binary logistic models were performed to identify factors associated with informal care.

RESULTS

123 patients reported having received informal care. A progressive reduction of the number of hours of care was observed between phases. Monetary value per patient ranged from 1,288 to 3,409; 1,045 to 2,786; and 336 to 854 €/month in the short, medium and long term, respectively. Patients with acute leukaemia and those who received an unrelated allogeneic transplantation were 22% (short-term) and 33.5% (medium-term) more likely to receive more than 8hours/day of care respect to patients diagnosed with lymphoma and autologous transplantation. In the long term, patients with multiple myeloma were more likely to receive more care. Better health status and higher educational level were associated with fewer daily hours of care.

CONCLUSIONS

Informal care varies greatly between stages of the treatment depending on the clinical and sociodemographic factors. Significant caring time and societal costs are associated with such care in blood cancer patients.

摘要

目的

评估血癌患者治疗各阶段中与非正式照护相关的经济价值、社会人口统计学因素及临床因素的差异。

方法

139例接受干细胞移植的血液系统癌症患者根据治疗的三个阶段完成了一份纵向调查问卷:短期(移植前)、中期(移植后第1年)和长期(移植后第2 - 6年)。使用替代商品法和机会成本法评估非正式照护的经济价值。采用有序和二元逻辑模型来确定与非正式照护相关的因素。

结果

123例患者报告接受了非正式照护。各阶段间照护时长呈逐渐减少趋势。每位患者的货币价值在短期、中期和长期分别为1288至3409欧元/月、1045至2786欧元/月和336至854欧元/月。与诊断为淋巴瘤和接受自体移植的患者相比,急性白血病患者以及接受无关供者异基因移植的患者在短期(22%)和中期(33.5%)每天接受超过8小时照护的可能性更高。长期来看,多发性骨髓瘤患者接受更多照护的可能性更大。健康状况较好和教育水平较高与每日照护时长较少相关。

结论

根据临床和社会人口统计学因素,非正式照护在治疗各阶段差异很大。血癌患者的此类照护涉及大量的照护时间和社会成本。

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