Kim Eunkyoung, Cho Yoon-Min, Kwon Soonman, Park Kunhee
School of Public Health, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea; World Health Organization Collaborating Centre for Health Systems and Financing, Seoul National University, 1 Kwanak-ro, Kwanak-gu, Seoul 151-742, Republic of Korea.
Pacific Health System and Policy, Division of Pacific Technical Support, Regional Office for the Western Pacific, World Health Organization, Level 4, Provident Plaza One, Downtown Boulevard, 33 Ellery Street, Suva, Fiji.
Cancer Epidemiol. 2017 Oct;50(Pt B):247-256. doi: 10.1016/j.canep.2017.02.008.
Rising demand for services of cancer patients has been recognised by the Government of Fiji as a national health priority. Increasing attention has been paid to the lack of service of radiation therapy or radiotherapy in Fiji.
This study aims to estimate and compare the costs and benefits of introducing radiation oncology services in Fiji from the societal perspective.
Time horizon for cost-benefit analysis (CBA) was 15 years from 2021 to 2035. The benefits and costs were converted to the present values of 2016. Estimates for the CBA model were taken from previous studies and expert opinions and data obtained from field visits to Fiji in January 2016. Sensitivity analyses with changing assumptions were undertaken.
The estimated net benefit, applying the national minimum wage (NMW) to measure monetary value for life-year gained, was -31,624,421 FJD with 0.69 of benefit-cost (B/C) ratio. If gross national income (GNI) per capita was used for the value of life years, net benefit was 3,975,684 FJD (B/C ratio: 1.04). With a pessimistic scenario, establishing the center appeared to be not cost-beneficial, and the net benefit was -53,634,682 FJD (B/C ratio: 0.46); net benefit with an optimistic scenario was estimated 23,178,189 FJD (B/C ratio: 1.20).
Based on the CBA results from using GNI per capita instead of the NMW, this project would be cost-beneficial. Introducing a radiation oncology center in Fiji would have potential impacts on financial sustainability, financial protection, and accessibility and equity of the health system.
斐济政府已认识到癌症患者对服务的需求不断增加是一项国家卫生重点事项。斐济放射治疗服务的短缺问题已受到越来越多的关注。
本研究旨在从社会角度估算并比较在斐济引入放射肿瘤学服务的成本和效益。
成本效益分析（CBA）的时间跨度为2021年至2035年的15年。效益和成本被转换为2016年的现值。CBA模型的估算取自先前的研究、专家意见以及2016年1月对斐济实地考察获得的数据。进行了假设变化的敏感性分析。
使用国家最低工资（NMW）来衡量生命年的货币价值时，估计的净效益为-31,624,421斐济元，效益成本（B/C）比为0.69。如果使用人均国民总收入（GNI）来衡量生命年的价值，净效益为3,975,684斐济元（B/C比：1.04）。在悲观情景下，建立该中心似乎没有成本效益，净效益为-53,634,682斐济元（B/C比：0.46）；乐观情景下的净效益估计为23,178,189斐济元（B/C比：1.20）。
基于使用人均国民总收入而非国家最低工资的成本效益分析结果，该项目将具有成本效益。在斐济引入放射肿瘤学中心将对卫生系统的财务可持续性、财务保护以及可及性和公平性产生潜在影响。
