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癌症相关成本应以可比方式进行分配——对2012 - 2017年北欧国家的癌症成本进行基准分析。

Cancer-related costs should be allocated in a comparable way-benchmarking costs of cancer in Nordic countries 2012-2017.

作者信息

Torkki Paulus, Leskelä Riikka-Leena, Bugge Christoffer, Torfadottir Johanna Eyrun, Karjalainen Sakari

机构信息

Department of Public Health, University of Helsinki, Helsinki, Finland.

NHG Finland Ltd., Helsinki, Finland.

出版信息

Acta Oncol. 2022 Oct;61(10):1216-1222. doi: 10.1080/0284186X.2022.2124883. Epub 2022 Sep 24.

Abstract

BACKGROUND

High costs of cancer, and especially the increase in treatment costs, have raised concerns about the financial sustainability of publicly funded health care systems around the world. As cancers get more prevalent with age, treatment costs are expected to keep rising with aging populations. The objective of the study is to analyze the changes in cost of cancer care broken down into separate cost components and outcomes of cancer treatment in the Nordic countries 2012-2017.

MATERIALS AND METHODS

We estimated direct costs of cancer based on retrospective data from national registers: outpatient care and inpatient care in primary care and specialized care as well as medicine costs. The number of cancer cases and survival data was obtained from NORDCAN. Cancer was defined as ICD-10 codes C00-C97.

RESULTS

Healthcare costs of cancer in real terms increased in all countries: CAGR was between 1 and 6% depending on the country. Medicine costs have increased rapidly (37-125%) in all countries during the observation period. In Finland and Denmark, inpatient care costs have decreased, whereas in Iceland, Norway, and Sweden, they have increased, although the number of inpatient days has decreased everywhere. The age-standardized cancer mortality has decreased constantly over time.

CONCLUSION

Cancer care in Nordic countries has significant differences in both cost structures and in the development of cost drivers, indicating differences in the organization of care and different focus in health policy. It is important to compare the cancer care costs internationally on a detailed level to understand the reasons for cost development. The registration of cost data, especially medicine costs, should be more standardized to enable better cost and outcomes comparisons between countries in the future.

摘要

背景

癌症治疗成本高昂,尤其是治疗费用的增加,引发了全球对公共资助医疗保健系统财务可持续性的担忧。随着癌症发病率随年龄增长而升高,预计治疗成本将随着人口老龄化而持续上升。本研究的目的是分析2012 - 2017年北欧国家癌症护理成本的变化,这些成本细分为单独的成本组成部分以及癌症治疗的结果。

材料与方法

我们根据国家登记处的回顾性数据估算癌症的直接成本:初级保健和专科护理中的门诊护理和住院护理以及药品成本。癌症病例数和生存数据来自北欧癌症登记处(NORDCAN)。癌症定义为国际疾病分类第十版(ICD - 10)编码C00 - C97。

结果

所有国家的癌症医疗保健成本实际均有所增加:根据国家不同,复合年增长率在1%至6%之间。在观察期内,所有国家的药品成本都迅速增加(37% - 125%)。在芬兰和丹麦,住院护理成本有所下降,而在冰岛、挪威和瑞典,尽管各地住院天数减少,但住院护理成本却有所增加。年龄标准化癌症死亡率随时间持续下降。

结论

北欧国家的癌症护理在成本结构和成本驱动因素的发展方面存在显著差异,这表明护理组织方式不同以及卫生政策重点不同。在国际层面详细比较癌症护理成本对于理解成本发展的原因很重要。成本数据的登记,尤其是药品成本的登记,应更加标准化,以便未来能够更好地比较各国的成本和结果。

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