美国军事医疗体系中医疗来源对癌症治疗费用变化的影响。

Contribution Of Care Source To Cancer Treatment Cost Variation In The US Military Health System.

机构信息

Yvonne L. Eaglehouse is a health services researcher in the Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences (USUHS); is an assistant professor in the Department of Surgery at USUHS; and is employed by the Henry M. Jackson Foundation for the Advancement of Military Medicine, all in Bethesda, Maryland.

Mayada Aljehani is a biostatistician in the Lawrence J. Ellison Institute for Transformative Medicine, University of Southern California (USC), in Los Angeles.

出版信息

Health Aff (Millwood). 2019 Aug;38(8):1335-1342. doi: 10.1377/hlthaff.2019.00283.

DOI:10.1377/hlthaff.2019.00283

PMID:31381409

Abstract

The US Military Health System (MHS) provides universal access to health care for more than nine million eligible beneficiaries through direct care in military treatment facilities or purchased care in civilian facilities. Using information from linked cancer registry and administrative databases, we examined how care source contributed to cancer treatment cost variation in the MHS for patients ages 18-64 who were diagnosed with colon, female breast, or prostate cancer in the period 2003-14. After accounting for patient, tumor, and treatment characteristics, we found the independent contribution of care source to total variation in cost to be 8 percent, 12 percent, and 2 percent for colon, breast, and prostate cancer treatment, respectively. About 20-50 percent of the total cost variance remained unexplained and may be related to organizational and administrative factors.

摘要

美国军事卫生系统 (MHS) 通过军事医疗机构的直接护理或民营医疗机构的购买服务，为超过 900 万名符合条件的受益人提供普遍的医疗服务。我们利用来自癌症登记和行政数据库的信息，研究了在 2003-14 年期间，年龄在 18-64 岁之间被诊断患有结肠癌、女性乳腺癌或前列腺癌的患者中，医疗服务来源如何影响 MHS 中癌症治疗费用的变化。在考虑了患者、肿瘤和治疗特征后，我们发现医疗服务来源对结肠癌、乳腺癌和前列腺癌治疗总成本变化的独立贡献分别为 8%、12%和 2%。大约 20-50%的总成本差异仍然无法解释，可能与组织和管理因素有关。