The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
Surgery. 2020 Jun;167(6):985-990. doi: 10.1016/j.surg.2020.02.029. Epub 2020 Apr 15.
Gastrointestinal cancers contribute substantially to the cost of health care. We sought to quantify and compare the financial burden associated with treatment of gastrointestinal cancers versus other common nongastrointestinal cancers.
The Medical Expenditure Panel Survey from 2006 to 2015 was used to identify individuals with gastrointestinal cancer, other nongastrointestinal cancer (breast/prostate or lung), or no history of malignancy. Total and out-of-pocket medical expenditures were compared. Among each cohort, risk of high and catastrophic financial burden was determined.
A total of 90,344 individuals were identified, which was extrapolated to a national representative sample of 95,449,062 individuals. Overall, an estimated 365,367 (0.4%) individuals had a gastrointestinal cancer while 2,015,724 (2.1%) had lung, breast, or prostate cancer. Mean adjusted total health expenditures was greater among patients with gastrointestinal cancer ($13,716; 95% confidence interval, $9,805-$17,628) versus patients with nongastrointestinal cancer ($8,665; 95% confidence interval, $8,222-$9,108) or individuals without cancer ($5,807; 95% confidence interval $5,740-$5,874). An estimated 15.8% (n = 57,898) and 7.1% (n = 25,956) of patients with gastrointestinal cancer experienced a high and catastrophic financial burden, respectively. Patients with gastrointestinal cancer had a 64% increased odds of experiencing catastrophic financial burden compared with patients without a history of cancer (odds ratio 1.64, 95% confidence interval, 1.17-2.31). Furthermore, patients with a gastrointestinal cancer had nearly 40% increased odds of high financial burden associated with their care compared with patients without cancer (odds ratio 1.37; 95% confidence interval, 1.00-1.88).
The risk of experiencing catastrophic financial burden among patients with gastrointestinal cancer was considerable, as roughly 1 in 7 patients experienced high financial burden, and 1 in 13 had a catastrophic financial burden.
胃肠道癌症在医疗保健成本中占很大比重。我们旨在量化和比较胃肠道癌症与其他常见非胃肠道癌症治疗相关的经济负担。
使用 2006 年至 2015 年的医疗支出面板调查（Medical Expenditure Panel Survey），以确定患有胃肠道癌、其他非胃肠道癌（乳腺癌/前列腺癌或肺癌）或无恶性肿瘤病史的个体。比较总医疗支出和自付医疗支出。在每个队列中，确定高和灾难性经济负担的风险。
共确定了 90344 人，外推至全国有代表性的 95449062 人样本。总体而言，估计有 365367（0.4%）人患有胃肠道癌，2015724（2.1%）人患有肺癌、乳腺癌或前列腺癌。与患有非胃肠道癌（$8665; 95%置信区间，$8222-$9088）或无癌症（$5807; 95%置信区间，$5740-$5874）的患者相比，患有胃肠道癌的患者的平均调整后总健康支出更高（$13716; 95%置信区间，$9805-$17628）。估计有 15.8%（n=57898）和 7.1%（n=25956）的胃肠道癌患者分别经历了高和灾难性的经济负担。与无癌症史的患者相比，患有胃肠道癌的患者发生灾难性经济负担的可能性增加了 64%（比值比 1.64，95%置信区间，1.17-2.31）。此外，与无癌症的患者相比，患有胃肠道癌症的患者在其护理方面发生高财务负担的可能性增加了近 40%（比值比 1.37; 95%置信区间，1.00-1.88）。
胃肠道癌患者发生灾难性经济负担的风险相当大，大约每 7 名患者中就有 1 名患者经历了高财务负担，每 13 名患者中就有 1 名患者面临灾难性的经济负担。
