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[哥伦比亚麦德林一家专业癌症中心治疗的乳腺癌患者因医保类型导致的生存差异]

[Survival difference due to types of health coverage in breast cancer patients treated at a specialized cancer center in Medellín, Colombia].

作者信息

Egurrola-Pedraza Jorge Armando, Gómez-Wolff Luis Rodolfo, Ossa-Gómez Carlos Andrés, Sánchez-Jiménez Viviana, Herazo-Maya Fernando, García-García Héctor Iván

机构信息

Universidad de Antioquia, Medellín, Colombia.

Instituto de Cancerología Las Américas, Medellín, Colombia.

出版信息

Cad Saude Publica. 2018 Dec 20;34(12):e00114117. doi: 10.1590/0102-311X00114117.

Abstract

The study aimed to estimate the effect of health insurance on overall survival and disease-free survival in breast cancer patients undergoing surgery at the Las Américas Oncology Institute in Medellín, Colombia, with data from the institutional registry. The variables were compared between subsidized coverage and contributive coverage with chi-squared test (χ2) or Student t test, Kaplan-Meier, and log-rank test. The target variable was adjusted with Cox regression. There were 2,732 patients with a median follow-up of 36 months. Ten percent of the women with contributive coverage died, compared to 23% of the subsidized coverage group. There were differences in time-to-treatment (contributive group with 52 days versus subsidized group with 112 days, p < 0.05). Disease-free survival and overall survival were better in women with contributive coverage compared to those with subsidized coverage (p < 0.05), and overall survival varied according to tumor and treatment variables. Overall survival and disease-free survival and early time-to-diagnosis and treatment were better in patients with contributive coverage compared to those with subsidized coverage.

摘要

该研究旨在利用来自机构登记处的数据,评估医疗保险对在哥伦比亚麦德林市拉斯美洲肿瘤研究所接受手术的乳腺癌患者总生存期和无病生存期的影响。采用卡方检验(χ2)或学生t检验、Kaplan-Meier法和对数秩检验对补贴保险和缴费型保险之间的变量进行比较。目标变量通过Cox回归进行调整。共有2732例患者,中位随访时间为36个月。缴费型保险覆盖的女性中有10%死亡,而补贴保险覆盖组为23%。治疗时间存在差异(缴费型组为52天,补贴组为112天,p<0.05)。与补贴保险覆盖的女性相比,缴费型保险覆盖的女性无病生存期和总生存期更好(p<0.05),并且总生存期根据肿瘤和治疗变量而有所不同。与补贴保险覆盖的患者相比,缴费型保险覆盖的患者总生存期、无病生存期以及早期诊断和治疗时间更好。

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