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中国视网膜母细胞瘤患者的经济负担。

Economic burden for retinoblastoma patients in China.

作者信息

Zhou Yuchen, Cai Siyu, Jin Mei, Jiang Chiyi, Xu Na, Duan Chao, Peng Xiaoxia, Zhao Junyang, Ma Xiaoli

机构信息

Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National center for children's health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Beijing, China.

Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National center for children's health, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.

出版信息

J Med Econ. 2020 Dec;23(12):1553-1557. doi: 10.1080/13696998.2020.1831518. Epub 2020 Oct 27.

Abstract

BACKGROUND

Although retinoblastoma (Rb) is considered to have a good prognosis, economical stress is still a huge problem for patients' families. Besides, doctors, the government, and social foundation staff do not precisely know how much is truly required for complete Rb therapy, especially the non-medical costs and indirect costs. This study was conducted to estimate the economic burden of Rb patients.

METHODS

This was a retrospective study. Fifty Rb patients were finally enrolled in the study. The questionnaire survey was conducted with surviving Rb patient' main family caregivers to collect the information on costs during illness through the phone. Costs included direct and indirect cost; direct costs included medical and non-medical costs. Medical costs include drug costs, surgery costs, treatment fees, lab tests, non-lab tests costs, and medical consumptive stuff costs (including hospital expenses and outpatient fees).

RESULTS

The total direct cost was $27,814.62 ± 15,137.73, and the average medical cost was $15,034.48 ± 8,224.19 ($3,963.99-36,826.53). The total non-medical expenses averaged $12,252.93 ± 9,872.64 ($728.86-48,104.95). The average reduced working time was 11.50 ± 8.06 months, and the average lost income was $13,512.23 ± 11,545.83. Among the non-medical expenses, the average non-medical expenses for children in Beijing and surrounding areas was $6,557.68 ± 6,385.42, and the average non-medical expenses for children in other provinces and was $14,502.29 ± 10,484.86, -test -value = 0.011. The average transportation cost for children in Beijing and surrounding areas (Hebei, Tianjin) was $1,871.09 ± 1,428.91, other provinces was $4,909.62 ± 3,697.02. Of children in Beijing and surrounding areas the average accommodation fee was $2,788.42 ± 3,065.00, in other provinces it was $6,599.27 ± 3,065.00.

CONCLUSION

Children with Rb have a heavy economic burden. Direct non-medical expenses are higher. Getting medical treatment nearby can help reduce the economic burden of the disease. Besides, work-related issues are also a major financial problem for families with Rb, and the government should properly provide economic subsidies. Simplifying the national health insurance process and purchasing commercial supplementary medical insurance will increase the family's ability to afford the cost of cancer treatment.

摘要

背景

尽管视网膜母细胞瘤(Rb)被认为预后良好,但经济压力对患者家庭来说仍是一个巨大问题。此外,医生、政府和社会基金会工作人员并不确切知道Rb完全治疗真正需要多少费用,尤其是非医疗费用和间接费用。本研究旨在评估Rb患者的经济负担。

方法

这是一项回顾性研究。最终有50例Rb患者纳入本研究。通过电话对存活的Rb患者的主要家庭照顾者进行问卷调查,以收集疾病期间的费用信息。费用包括直接和间接费用;直接费用包括医疗和非医疗费用。医疗费用包括药品费用、手术费用、治疗费、实验室检查、非实验室检查费用以及医疗耗材费用(包括住院费用和门诊费用)。

结果

总直接费用为27,814.62美元±15,137.73美元,平均医疗费用为15,034.48美元±8,224.19美元(3,963.99 - 36,826.53美元)。总非医疗费用平均为12,252.93美元±9,872.64美元(728.86 - 48,104.95美元)。平均工作时间减少11.50±8.06个月,平均收入损失为13,512.23美元±11,545.83美元。在非医疗费用中,北京及周边地区儿童的平均非医疗费用为6,557.68美元±6,385.42美元,其他省份儿童的平均非医疗费用为14,502.29美元±10,484.86美元,t检验值 = 0.011。北京及周边地区(河北、天津)儿童的平均交通费用为1,871.09美元±1,428.91美元,其他省份为4,909.62美元±3,697.02美元。北京及周边地区儿童的平均住宿费为2,788.42美元±3,065.00美元,其他省份为6,599.27美元±3,065.00美元。

结论

Rb患儿经济负担沉重。直接非医疗费用较高。在附近就医有助于减轻疾病的经济负担。此外,与工作相关的问题也是Rb患儿家庭的一个主要经济问题,政府应适当提供经济补贴。简化国家医疗保险流程并购买商业补充医疗保险将提高家庭承担癌症治疗费用的能力。

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