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斯里兰卡口腔癌患者管理的经济负担:一项基于医院横断面的成本核算研究。

Economic burden of managing oral cancer patients in Sri Lanka: a cross-sectional hospital -based costing study.

作者信息

Amarasinghe Hemantha, Jayasinghe Ruwan Duminda, Dharmagunawardene Dilantha, Attygalla Manjula, Scuffham Paul A, Johnson Newell, Kularatna Sanjeewa

机构信息

Institute of Oral health, Maharagama, Sri Lanka.

Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Queensland, Australia.

出版信息

BMJ Open. 2019 Jul 19;9(7):e027661. doi: 10.1136/bmjopen-2018-027661.

Abstract

OBJECTIVE

Cancer of the oral cavity is the leading malignancy among males in Sri Lanka, and sixth among women. This study aimed to estimate costs of managing patients with oral cancer (OCA) in Sri Lanka for a 12 month period from diagnosis.

DESIGN

Hospital based costing study.

SETTINGS

Four selected cancer treatment centres in Sri Lanka.

PARTICIPANTS

Sixty-nine OCA patients: 60 were males and 12 had recurrent tumours.

OUTCOME

Societal perspectives (healthcare, household and indirect costs) were itemised. Costs to the healthcare system included surgery, Intensive Care Unit (ICU) care, chemotherapy and radiotherapy. Capital costs including apportioned value of land, buildings, equipment and furniture. Household costs consisted of out of pocket expenditure for healthcare and indirect costs of lost income. Costs were estimated from the stage of presentation for treatment to 1 year of follow-up.

RESULTS

Mean cost of managing a single stage II OCA patient for 1 year was Sri Lankan rupees (SLR) 58 979 (US$394, at the midyear exchange rate in 2016) to the health system. Mean household cost was SLR 77 649 (US$518). The annual cost of managing a stage III or IV patient was SLR 303 620 (US$2027), with household costs of SLR 71 932 (US$480).

CONCLUSIONS

Owing to the high incidence of OCA in Sri Lanka, the economic costs associated with these diseases are enormous, resulting in negative impacts on both the healthcare system and individual families, seriously impacting the country's economy. Policy-makers should take note of this burden and increase steps for prevention and control of this devastating disease.

摘要

目的

口腔癌是斯里兰卡男性中最主要的恶性肿瘤,在女性中排第六位。本研究旨在估算斯里兰卡口腔癌(OCA)患者从确诊起12个月的治疗费用。

设计

基于医院的成本核算研究。

地点

斯里兰卡四家选定的癌症治疗中心。

参与者

69例OCA患者,其中60例为男性,12例有复发性肿瘤。

结果

按社会视角(医疗保健、家庭和间接成本)进行分项统计。医疗保健系统的成本包括手术、重症监护病房(ICU)护理、化疗和放疗。资本成本包括土地、建筑物、设备和家具的分摊价值。家庭成本包括医疗保健的自付费用和收入损失的间接成本。成本估算从开始治疗阶段到随访1年。

结果

卫生系统管理一名II期OCA患者1年的平均成本为58979斯里兰卡卢比(2016年年中汇率下为394美元)。家庭平均成本为77649斯里兰卡卢比(518美元)。管理一名III期或IV期患者的年度成本为303620斯里兰卡卢比(2027美元),家庭成本为71932斯里兰卡卢比(480美元)。

结论

由于斯里兰卡OCA发病率高,与这些疾病相关的经济成本巨大,对医疗保健系统和单个家庭都产生了负面影响,严重影响了该国经济。政策制定者应注意到这一负担,并加强对这种毁灭性疾病的预防和控制措施。

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