Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina; University of Buenos Aires School of Medicine, Buenos Aires, Argentina; Center for Research in Epidemiology and Public Health (CIESP), National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
Institute Alexander Fleming, Buenos Aires, Argentina.
Value Health Reg Issues. 2024 May;41:94-99. doi: 10.1016/j.vhri.2023.12.001. Epub 2024 Jan 29.
Non-small cell lung cancer (NSCLC) is Argentina's first cause of cancer death. Most patients have an advanced stage at diagnosis, with poor expected survival. This study aimed to characterize the health-related quality of life (HRQOL) and economic impact of patients treated in the private healthcare sector and compare it with that of the public sector.
We undertook an observational cross-sectional study that extended a previous study to a referral private center in Argentina. Outcomes included the EuroQol EQ-5D-3L (to assess HRQOL), Comprehensive Score for Financial Toxicity (financial toxicity instrument), Work Productivity and Activity Impairment - General Health (to assess productivity loss), and out-of-pocket expenses in adults diagnosed of NSCLC.
We included 30 consecutive patients from a private healthcare center (July 2021 to March 2022), totaling 131 patients (n = 101 from previous public study). The whole sample had low quality of life and relevant economic impact. Patients in the private healthcare sector showed lower disease severity and higher educational level and household income. In addition, private healthcare system patients showed higher utility (0.77 vs 0.73; P < .05) and lower impairment of daily activities (41% vs 59%; P = .01). Private health system patients also showed lower financial toxicity as measured by the Comprehensive Score for Financial Toxicity score (23.9 vs 20.14; P < .05) but showed no differences when financial toxicity was assessed as a dichotomic variable.
Although patients with NSCLC treated in a private healthcare center in Argentina showed a relevant HRQOL and economic impact, this impact was smaller than the one observed in publicly funded hospitals.
非小细胞肺癌(NSCLC)是阿根廷癌症死亡的首要原因。大多数患者在诊断时已处于晚期,生存预期较差。本研究旨在描述私营医疗保健部门治疗的患者的健康相关生活质量(HRQOL)和经济影响,并将其与公共部门进行比较。
我们进行了一项观察性横断面研究,将之前的研究扩展到阿根廷的一家转诊私立中心。结果包括欧洲五维健康量表 3 级(EQ-5D-3L)(评估 HRQOL)、综合财务毒性评分(财务毒性工具)、工作生产力和活动障碍-一般健康(评估生产力损失),以及 NSCLC 确诊成人的自付费用。
我们纳入了一家私营医疗中心的 30 名连续患者(2021 年 7 月至 2022 年 3 月),共计 131 名患者(来自之前的公共研究 n = 101)。整个样本的生活质量和经济影响都较差。私营医疗保健部门的患者疾病严重程度较低,教育程度和家庭收入较高。此外,私营医疗保健系统的患者表现出更高的效用(0.77 对 0.73;P <.05)和更低的日常活动障碍(41%对 59%;P =.01)。综合财务毒性评分(23.9 对 20.14;P <.05)也显示出较低的财务毒性,而当财务毒性作为二分变量评估时,没有差异。
尽管阿根廷私营医疗保健中心治疗的 NSCLC 患者表现出显著的 HRQOL 和经济影响,但这一影响小于公共资助医院观察到的影响。