Paix Adrien, Popotte Hosni, Lévy Christine, Perez Adrianna, Bouillet Thierry, Zelek Laurent, Duchemann Boris
Institut de radiothérapie de Bobigny, rue Lautréamont, 93000 Bobigny, France.
Institut de radiothérapie de Bobigny, rue Lautréamont, 93000 Bobigny, France.
Bull Cancer. 2020 Nov;107(11):1129-1137. doi: 10.1016/j.bulcan.2020.09.003. Epub 2020 Oct 6.
Human, material, and financial resources being limited, the organization of the care system must allow an efficient allocation of resources. The management of cancers leads to specific and repetitive care for which the reimbursement of transport costs represents a high cost. We carried out an analysis of the additional transport costs, linked to the care of patients in Île-de-France, in a center other than the radiotherapy center closest to their home.
Using data from the Île-de-France Regional Health Agency, we have created a model evaluating the additional cost linked to transport generated by the care of a radiotherapy patient far from his home. In order to take into account the uncertainties linked to the hypotheses made in the development of the model, we carried out deterministic and probabilistic sensitivity analyzes.
In the base case, the additional annual cost related to transport was 841,176 euros in Île-de-France. The probabilistic sensitivity analysis reports a total annual additional cost of 2,817,481 euros.
Our results are similar to a report from the General Inspectorate of Social Affairs published in July 2011, which then pointed to an additional cost of between 4 and 6 million euros annually. The long-term care of cancer patients from their homes contributes to a deterioration in the quality of life linked to travel times, a delay in the care of potential treatment complications, and the spread of infectious diseases, such as COVID-19, and bacteria resistant to antibiotics.
由于人力、物力和财力资源有限，医疗系统的组织必须实现资源的有效分配。癌症治疗需要特定且重复的护理，其中交通费用的报销是一项高昂的成本。我们对法兰西岛大区患者在离家最近的放疗中心以外的其他中心接受治疗所产生的额外交通费用进行了分析。
利用法兰西岛大区卫生局的数据，我们创建了一个模型，用于评估放疗患者在离家较远的地方接受治疗所产生的与交通相关的额外费用。为了考虑模型开发中假设所涉及的不确定性，我们进行了确定性和概率性敏感性分析。
在基础案例中，法兰西岛大区与交通相关的年度额外费用为841,176欧元。概率性敏感性分析报告的年度额外总费用为2,817,481欧元。
我们的结果与2011年7月社会事务总监察局发布的一份报告相似，该报告当时指出每年的额外费用在400万至600万欧元之间。癌症患者在家中的长期护理会导致与出行时间相关的生活质量下降、潜在治疗并发症护理延迟，以及传染病（如COVID-19）和抗生素耐药细菌的传播。
