Oncol Res Treat. 2017;40(9):490-494. doi: 10.1159/000475759. Epub 2017 Aug 17.
Against the background of limited resources, the rise in the cost of therapy as well as in the number of cancer patients fuels the discussion about the necessity to ration, i.e., setting limits to beneficial treatment for cost reasons. Recently, we presented the self-reported prevalence of bedside rationing among German oncologists. Here, we describe oncologists' views on cost containment strategies and their role therein.
We performed an online survey including structured questions and free field sections with the members of the German Society of Hematology and Oncology.
In the perception of oncologists, cost considerations and negotiations are gaining in importance and consume considerable working time. This negatively affects job satisfaction in 72% of the 345 respondents. Oncologists are concerned that the quality of care will suffer from rationalization and implicit rationing. They are ambivalent as to who is best suited to decide about resource rationing: 66% support the view that limits for costly procedures should be set by a form of commission; nevertheless, 48% consider physicians as the best decision makers in these situations.
We suggest a broad public discussion and an interdisciplinary debate among the oncology community to define and legitimize decisions on rationing by setting explicit criteria.
在资源有限的情况下，治疗成本的上升以及癌症患者人数的增加引发了关于是否有必要进行配给的讨论，即出于成本原因限制有益治疗。最近，我们报告了德国肿瘤学家报告的床边配给的流行率。在这里，我们描述了肿瘤学家对成本控制策略的看法及其在其中的作用。
我们对德国血液学和肿瘤学学会的成员进行了在线调查，其中包括结构化问题和自由字段部分。
在肿瘤学家的看法中，成本考虑和谈判变得越来越重要，并且消耗了大量的工作时间。这对 345 名受访者中的 72%的工作满意度产生了负面影响。肿瘤学家担心，合理化和隐性配给会影响护理质量。他们对谁最适合决定资源配给持矛盾态度：66%的人支持由委员会为昂贵程序设定限制的观点；然而，48%的人认为在这些情况下医生是最佳决策者。
我们建议在肿瘤学界进行广泛的公众讨论和跨学科辩论，通过设定明确的标准来定义和合法化配给决策。
