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巴西癌症的成本分析:2001-2015 年公共卫生系统治疗患者的基于人群的研究。

Cost Analysis of Cancer in Brazil: A Population-Based Study of Patients Treated by Public Health System From 2001-2015.

机构信息

Postgraduate Program in Public Health, Medicine School, Federal University of Minas Gerais, Belo Horizonte-MG, Brazil.

National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.

出版信息

Value Health Reg Issues. 2020 Dec;23:137-147. doi: 10.1016/j.vhri.2020.05.008. Epub 2020 Nov 20.

Abstract

OBJECTIVES

The aim of this study was to evaluate the federal government expenditures with oncological care, for the most incident cancer types among the Brazilian population, using registries of all patients treated by the Brazilian National Health Service (SUS) between 2001 and 2015. We adopted the formal healthcare sector perspective in this study, with the costs per patient estimated by the reimbursement price paid by the Ministry of Health to service providers.

METHODS

The costs were adjusted by the follow-up time for each patient. We performed multivariate regression analysis using ordinary least squares. We analyzed 952 960 patients aged ≥19 years who underwent cancer treatment, between 2001 and 2015, for breast, prostate, colorectal, cervix, lung, and stomach cancers.

RESULTS

The annual mean costs per patient (in USD purchasing power parity) was $9572.30, varying from $5782.10 for breast cancer to $16 656 for cervical cancer. Several variables predicted higher costs of cancer treatment, namely: to be male (+14%), with younger age ranges at treatment initiation, resident in the Northeast region (+26%), treated for colorectal cancer (+482%), with treatment initiation from 2010 to 2014, tumor stages III and IV (III: +182%; IV: +165%), hospitalization for other reasons besides the cancer treatment, and suffering from some a comorbidity.

CONCLUSIONS

Given the forthcoming Brazilian demographic changes, which strongly suggest that the economic burden of cancer is about to increase in the near future, our estimates provide relevant information to produce useful projections about future cancer-related costs.

摘要

目的

本研究旨在评估巴西人口中最常见癌症类型的肿瘤治疗联邦政府支出,使用巴西国家卫生系统(SUS)在 2001 年至 2015 年期间治疗的所有患者的登记数据。本研究采用正规医疗保健部门的观点,根据卫生部向服务提供商支付的报销价格来估算每位患者的成本。

方法

我们对每位患者的随访时间进行了成本调整。我们使用普通最小二乘法进行多元回归分析。我们分析了 2001 年至 2015 年间,年龄在 19 岁及以上、患有乳腺癌、前列腺癌、结直肠癌、宫颈癌、肺癌和胃癌的 952960 名患者。

结果

每位患者的年平均治疗费用(按购买力平价计算的美元)为 9572.30 美元,从乳腺癌的 5782.10 美元到宫颈癌的 16656 美元不等。有几个变量可以预测癌症治疗费用更高,即:男性(增加 14%),发病年龄较小,来自东北部地区(增加 26%),患有结直肠癌(增加 482%),2010 年至 2014 年发病,肿瘤分期为 III 期和 IV 期(III 期:增加 182%;IV 期:增加 165%),因癌症治疗以外的其他原因住院治疗,患有某种合并症。

结论

鉴于巴西人口即将发生的变化,强烈表明癌症的经济负担即将在不久的将来增加,我们的估计为预测未来与癌症相关的成本提供了有用的信息。

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