Bae Jong-Myon
Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea.
J Prev Med Public Health. 2017 Jul;50(4):217-227. doi: 10.3961/jpmph.17.069. Epub 2017 Jun 16.
In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.
就过早死亡导致的寿命损失年数而言,癌症在韩国造成的负担最为沉重。为减轻癌症负担,韩国政府实施了癌症控制项目,旨在降低癌症发病率、提高生存率并降低癌症死亡率。然而,这些项目可能会自相矛盾地增加成本负担。例如,用于早期检测的癌症筛查项目可能会导致过度诊断和过度治疗,而家长式地提供医疗服务可能会导致防御性医疗或无效治疗。作为减轻癌症成本负担的一项实际措施,应建立适当的癌症护理。确保适当性需要医患沟通,以确保效用值得到共享,并就医疗服务做出自主决策。因此,通过确保以患者为中心的适当护理来减轻癌症成本负担的策略包括引入基于价值的医学、开展成本效用研究以及开发患者决策辅助工具。