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美国医院转移性乳腺癌患者的姑息治疗和医疗保健利用。

Palliative care and healthcare utilization among metastatic breast cancer patients in U.S. Hospitals.

机构信息

Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.

Center for Healthcare Management Science, Soonchunhyang University, Asan, Republic of Korea.

出版信息

Sci Rep. 2023 Mar 16;13(1):4358. doi: 10.1038/s41598-023-31404-2.

Abstract

There is a lack of research focused on understanding the different characteristics and healthcare utilization of metastatic breast cancer patients by palliative care use. This study aims to investigate trend of in-patient palliative care and its association with healthcare utilization among hospitalized metastatic breast cancer patients in the US. National Inpatient Sample (NIS) was used to identify nationwide metastatic breast cancer patients (n = 5209, weighted n = 25,961) from 2010 to 2014. We examined the characteristics of the study sample by palliative care and its association with healthcare utilization, measured by discounted hospital charges and length of stay. Multivariable survey regression models were used to identify predictors. Among 26,961 breast cancer patients, 19.0% had palliative care. Percentage of receiving palliative care during the period were gradually increased. Social factors including race, insurance types were also associated with a receipt of palliative care. Survey linear regression results showed that patients with palliative care were associated with 31% lower hospital charges, however, length of stays were not significantly associated. This study found evidence of who was associated with the receipt of palliative care and its relationship with healthcare utilization. This study also emphasizes the importance of receiving palliative care in patients with breast cancer, paving the way for future research into ways to improve palliative care in cancer patients. This study also found social differences and gave evidence of programs that could be used to help vulnerable groups in future health policy decisions.

摘要

目前缺乏针对了解接受姑息治疗的转移性乳腺癌患者的不同特征和医疗保健利用情况的研究。本研究旨在调查美国住院转移性乳腺癌患者姑息治疗的趋势及其与医疗保健利用的关系。本研究使用国家住院患者样本(NIS),于 2010 年至 2014 年期间确定了全国范围内的转移性乳腺癌患者(n=5209,加权 n=25961)。我们通过姑息治疗检查了研究样本的特征及其与医疗保健利用的关系,利用折扣医院收费和住院时间来衡量。使用多变量调查回归模型来确定预测因素。在 25961 名乳腺癌患者中,有 19.0%接受了姑息治疗。在此期间,接受姑息治疗的比例逐渐增加。社会因素,包括种族和保险类型,也与接受姑息治疗有关。调查线性回归结果表明,接受姑息治疗的患者的医院收费降低了 31%,但住院时间没有显著关联。本研究发现了与接受姑息治疗相关的因素及其与医疗保健利用之间的关系的证据。本研究还强调了乳腺癌患者接受姑息治疗的重要性,为未来研究改善癌症患者的姑息治疗铺平了道路。本研究还发现了社会差异,并为未来的卫生政策决策中为弱势群体提供帮助的方案提供了证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3194/10020145/9c6aeca6c3fe/41598_2023_31404_Fig1_HTML.jpg

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