School of Dentistry, Universidade Federal de Goiás (UFG), Goiânia, Goiás, Brazil.
Universidade de Brasília (UnB), Brasília, Federal District, Brazil.
PLoS One. 2021 Feb 17;16(2):e0246475. doi: 10.1371/journal.pone.0246475. eCollection 2021.
The efficiency of public policies includes the measurement of the health resources used and their associated costs. There is a lack of studies evaluating the economic impact of oral cancer (OC). This study aims to estimate the healthcare costs of OC in Brazil from 2008 to 2016. This is a partial economic evaluation using the gross costing top-down method, considering the direct healthcare costs related to outpatients, inpatients, intensive care units, and the number of procedures, from the perspective of the public health sector. The data were extracted from the Outpatient and Inpatient Information System of the National Health System, by diagnosis according to the 10th Revision of the International Classification of Diseases, according to sites of interest: C00 to C06, C09 and C10. The values were adjusted for annual accumulated inflation and expressed in 2018 I$ (1 I$ = R$2,044). Expenditure on OC healthcare in Brazil was I$495.6 million, which was composed of 50.8% (I$251.6 million) outpatient and 49.2% (I$244.0 million) inpatient healthcare. About 177,317 admissions and 6,224,236 outpatient procedures were registered. Chemotherapy and radiotherapy comprised the largest number of procedures (88.8%) and costs (94.9%). Most of the costs were spent on people over 50 years old (72.9%) and on males (75.6%). Direct healthcare costs in Brazil for OC are substantial. Outpatient procedures were responsible for the highest total cost; however, inpatient procedures had a higher cost per procedure. Men over 50 years old consumed most of the cost and procedures for OC. The oropharynx and tongue were the sites with the highest expenditure. Further studies are needed to investigate the cost per individual, as well as direct non-medical and indirect costs of OC.
公共政策的效率包括对所使用的卫生资源及其相关成本的衡量。目前缺乏评估口腔癌(OC)经济影响的研究。本研究旨在估计 2008 年至 2016 年巴西 OC 的医疗保健成本。这是一项使用自上而下的总费用法进行的部分经济评估,从公共卫生部门的角度考虑了与门诊、住院、重症监护病房和程序数量相关的直接医疗保健成本。数据来自国家卫生系统的门诊和住院病人信息系统,根据国际疾病分类第 10 次修订版的诊断进行提取,按关注部位分类:C00 至 C06、C09 和 C10。按 2018 年 I$(1 I$=R$2.044)表示的年度累计通胀进行了调整。巴西 OC 医疗保健支出为 4.956 亿 I$,其中 50.8%(2.516 亿 I$)为门诊支出,49.2%(2.440 亿 I$)为住院支出。共记录了 177317 次住院和 6224236 次门诊程序。化疗和放疗构成了最大数量的程序(88.8%)和费用(94.9%)。大部分费用发生在 50 岁以上人群(72.9%)和男性(75.6%)。巴西 OC 的直接医疗保健成本很高。门诊程序的总成本最高;然而,住院程序的每例程序成本更高。50 岁以上的男性消耗了 OC 大部分的费用和程序。口咽和舌是支出最高的部位。需要进一步研究 OC 的个体成本以及直接非医疗和间接成本。