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中低收入国家脑肿瘤神经外科治疗的筹资:障碍与策略的范围综述

Financing of Neurosurgical Care for Brain Tumors in Low- and Middle-Income Countries : A Scoping Review of Barriers and Strategies.

机构信息

Section of Neurosurgery, Department Aga Khan University Hospital, Karachi, Pakistan.

Medical College, Aga Khan University, Karachi, Pakistan.

出版信息

World Neurosurg. 2024 Sep;189:473-482.e3. doi: 10.1016/j.wneu.2024.06.067. Epub 2024 Jun 18.

Abstract

BACKGROUND

Making neurosurgical care accessible to a larger portion of the population in low- and middle-income countries (LMICs) is integral due to the high mortality and morbidity associated with brain tumors. However, the high cost of care often makes it financially out of reach for many individuals. Therefore, this review aims to identify barriers to neurosurgical care of brain tumors in terms of financing in LMICs.

METHODS

Without restriction to language, a search of the literature was undertaken in a number of databases, including PubMed, Scopus, Google Scholar, and CINAHL, in order to find the most pertinent research involving financing of brain tumors in LMICs. The last day of the search was October 20, 2022. Following screening and data extraction, significant themes were found and categorized using thematic analysis.

RESULTS

A total of 28 studies were analyzed in this review. The review highlighted some of the barriers to providing surgical care of brain tumors in LMICs. In the cited studies, surgical expenses (41%), neuroimaging costs (30%), and care-related expenses (33%) were the primary concerns. Addressing these challenges involves cross-border collaboration (23%), transparent financing systems (46%), awake craniotomy (15%), cost-effective/reusable intra-operative supplies (8%), and optimizing resources in healthcare systems (8%).

CONCLUSIONS

This study explored barriers and challenges to financing neurosurgical care of brain tumors in LMICs. Government support and transparency in healthcare financing should be prioritized to ensure that all individuals have access to surgical care of brain tumors.

摘要

背景

由于脑瘤相关的高死亡率和高发病率,使中低收入国家(LMICs)的更多人获得神经外科护理至关重要。然而,高昂的治疗费用往往使许多人难以负担。因此,本综述旨在确定中低收入国家脑瘤神经外科治疗的融资障碍。

方法

本研究在多个数据库(包括 PubMed、Scopus、Google Scholar 和 CINAHL)中进行了文献搜索,无语言限制,以寻找涉及中低收入国家脑瘤融资的最相关研究。搜索的最后一天是 2022 年 10 月 20 日。经过筛选和数据提取,使用主题分析找到了并对重要主题进行了分类。

结果

本综述共分析了 28 项研究。综述强调了中低收入国家提供脑瘤外科治疗的一些障碍。在引用的研究中,手术费用(41%)、神经影像学成本(30%)和相关护理费用(33%)是主要关注点。解决这些挑战涉及跨境合作(23%)、透明的融资系统(46%)、清醒开颅术(15%)、具有成本效益/可重复使用的术中用品(8%)以及优化医疗保健系统中的资源(8%)。

结论

本研究探讨了中低收入国家脑瘤神经外科治疗融资的障碍和挑战。政府支持和医疗保健融资透明度应是优先事项,以确保所有人都能获得脑瘤的外科治疗。

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