Institute for Research on Population and Social Policies, National Research Council, 00185 Rome, Italy.
Centro Nazionale per la Prevenzione delle Malattie e la Promozione della Salute, Istituto Superiore di Sanità, 00161 Roma, Italy.
Int J Environ Res Public Health. 2021 Jan 8;18(2):474. doi: 10.3390/ijerph18020474.
Costs of cancer care are increasing worldwide, and sustainability of cancer burden is critical. In this study, the economic impact of rectal cancer on the Italian healthcare system, measured as public healthcare expenditure related to investigation and treatment of rectal cancer patients is estimated. A cross-sectional cohort of 9358 rectal cancer patients is linked, on an individual basis, to claims associated to rectal cancer diagnosis and treatments. Costs refer mainly to years 2010-2011 and are estimated by phase of care, as healthcare needs vary along the care pathway: diagnostic procedures are mainly provided in the first year, surveillance procedures are addressed to chronically ill patients, and end-of-life procedures are given in the terminal status. Clinical approaches and corresponding costs are specific by cancer type and vary by phase of care, stage at diagnosis, and age. Surgery is undertaken by the great majority of patients. Thus, hospitalization is the main cost driver. The evidence produced can be used to improve planning and allocation of healthcare resources. In particular, early diagnosis of rectal cancer is a gain in healthcare budget. Policies raising spreading of and adherence to screening plans, above all when addressed to people living in Southern Italy, should be strongly encouraged.
癌症治疗成本在全球范围内不断增加，因此癌症负担的可持续性至关重要。本研究旨在评估意大利医疗保健系统中直肠癌的经济影响，具体而言，是指与直肠癌患者的诊断和治疗相关的公共医疗支出。研究将 9358 例直肠癌患者的横断面队列，按个体进行链接，以获取与直肠癌诊断和治疗相关的索赔。成本主要参考 2010 年至 2011 年的数据，并按护理阶段进行估计，因为护理路径中医疗需求会有所不同：诊断程序主要在第一年进行，监测程序针对慢性病患者，临终关怀程序则在临终状态下进行。不同癌症类型的临床方法和相应的成本不同，而且会因护理阶段、诊断时的分期和年龄而有所不同。大多数患者都接受了手术治疗，因此，住院治疗是主要的成本驱动因素。本研究提供的证据可用于改善医疗保健资源的规划和分配。特别是，直肠癌的早期诊断可以节省医疗预算。应该大力鼓励实施和遵守筛查计划的政策，尤其是针对居住在意大利南部的人群。
