Department of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kawasaki City, Japan.
Departments of Internal Medicine and Psychiatry, University of Minnesota, Minneapolis, MN.
J Acad Consult Liaison Psychiatry. 2021 Mar-Apr;62(2):228-233. doi: 10.1016/j.psym.2020.06.008. Epub 2020 Jun 16.
Little is known about how behavioral health (BH) conditions affect health care costs of patients with cancer in Japan.
The purpose of this study is to evaluate the magnitude of general medical claims expenditures for individuals with cancer who use or do not use BH services in Japan.
The study used a health insurance claims database for more than 3 million enrollees in Japan. All health plan enrollees (18 y or older) who had tumors without metastasis or metastatic solid tumors defined by the Charlson Comorbidity Index were included in the study (n = 20,260). Measurements included total claims expenditures for BH and medical services.
The proportion of enrollees using BH services was 12.8%. BH service users accounted for 17.7% of total health service spending. Mean annual cost of total health care services were 1.5 times higher in BH users than those with no BH use, whereas the median was 1.8 times higher. Mean annual medical cost alone for BH users was 1.3 times higher than that for non-BH users, whereas the median was 1.5 times higher.
The findings suggest the importance for the Japanese medical system to address BH needs of patients with cancer and introduce fiscal efficiencies to cancer care. Strategic implementation of effective integrated care services for patients with cancer should be considered in Japan.
关于行为健康(BH)状况如何影响日本癌症患者的医疗保健费用,知之甚少。
本研究旨在评估在日本使用或不使用 BH 服务的癌症患者的一般医疗费用支出的幅度。
本研究使用了日本超过 300 万被保险人的健康保险索赔数据库。所有健康计划被保险人(18 岁或以上)中没有转移或转移性实体肿瘤的肿瘤患者,均符合 Charlson 合并症指数的定义,被纳入本研究(n=20260)。测量包括 BH 和医疗服务的总索赔支出。
使用 BH 服务的被保险人比例为 12.8%。BH 服务使用者占总医疗服务支出的 17.7%。BH 用户的年度总医疗保健服务费用平均是无 BH 用户的 1.5 倍,中位数则是 1.8 倍。BH 用户的年度医疗费用平均值比非 BH 用户高 1.3 倍,中位数则高 1.5 倍。
这些发现表明日本医疗系统需要重视癌症患者的 BH 需求,并为癌症护理引入财政效率。在日本,应考虑为癌症患者实施有效的综合护理服务的战略实施。