Callander Emily, Bates Nicole, Lindsay Daniel, Larkins Sarah, Preston Robyn, Topp Stephanie M, Cunningham Joan, Garvey Gail
Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
Asia Pac J Clin Oncol. 2019 Dec;15(6):309-315. doi: 10.1111/ajco.13180. Epub 2019 Jul 16.
To quantify the direct out-of-pocket patient co-payments and time opportunity costs (length of hospital stay) incurred by Indigenous and non-Indigenous persons diagnosed with cancer during the first year postdiagnosis.
CancerCostMod was used, which is a model of cancer costs based upon a whole-of-population data linkage. The base population was a census of all persons diagnosed with cancer in Queensland, Australia between 1 July 2011 and 30 June 2012 (n = 25,553). Individual records were linked to corresponding Queensland Health Admitted Patient Data Collection, Emergency Data Information System, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between 1 July 2011 and 30 June 2015. Queensland data were weighted to be representative of the Australian population (approximately 123,900 Australians, 1.7% Indigenous Australians).
After adjusting for age, sex, rurality, area-based deprivation, and cancer group, Indigenous Australians accrued significantly less in postdiagnosis patient co-payments at 0-6 months (61% less) and 7-12 months (63% less). Indigenous Australians also had significantly fewer postdiagnosis hospitalizations at 0-6 months (21% fewer) and 7-12 months (27% fewer).
There is growing concern regarding the financial burden of cancer to the patient. The time spent away from family and their community may also have an important time opportunity cost, which may affect a person's decision to undertake or continue treatment. This is the first study in Australia to identify the financial cost of co-payments for Indigenous people with cancer, as well as the number and length of hospitalizations as drivers of time opportunity costs.
量化确诊癌症的原住民和非原住民在确诊后第一年产生的直接自付患者费用和时间机会成本（住院时间）。
使用了CancerCostMod，这是一个基于全人群数据链接的癌症成本模型。基础人群是2011年7月1日至2012年6月30日期间在澳大利亚昆士兰州确诊癌症的所有人的普查数据（n = 25,553）。个体记录与2011年7月1日至2015年6月30日期间相应的昆士兰卫生住院患者数据收集、急诊数据信息系统、医疗保险福利计划和药品福利计划记录相链接。昆士兰的数据经过加权以代表澳大利亚人口（约123,900名澳大利亚人，其中1.7%为原住民澳大利亚人）。
在调整年龄、性别、农村地区、基于地区的贫困程度和癌症类型后，原住民澳大利亚人在确诊后0至6个月（少61%）和7至12个月（少63%）的患者自付费用显著减少。原住民澳大利亚人在确诊后0至6个月（少21%）和7至12个月（少27%）的住院次数也显著减少。
人们越来越关注癌症给患者带来的经济负担。远离家庭和社区所花费的时间也可能产生重要的时间机会成本，并可能影响一个人决定接受或继续治疗。这是澳大利亚第一项确定癌症原住民患者自付费用的经济成本以及住院次数和住院时间作为时间机会成本驱动因素的研究。
