Hunter Rachael Maree, Huynh Jennie, Lüchtenborg Margreet, Armes Jo, Plugge Emma, Taylor Rachel M, Visser Renske, Davies Elizabeth A
Applied Health Research, Institute of Epidemiology and Health Care, University College London, United Kingdom.
Cancer Epidemiology and Cancer Services Research, Centre for Cancer, Society & Public Health, Comprehensive Cancer Centre, King's College London, United Kingdom.
EClinicalMedicine. 2024 Apr 29;72:102575. doi: 10.1016/j.eclinm.2024.102575. eCollection 2024 Jun.
People in prison experience poorer mental and physical health compared to their peers in the general population. The causes are multi-dimensional ranging from lifestyle factors to poorer access to healthcare. Little is known about cancer in people in prison or how the cost of their care compares to the general population.
Data on people diagnosed with cancer while in English prisons were identified in National Cancer Registration dataset and linked to Hospital Episode Statistics (HES) for the years 2012-2017. General population matched patients were identified using a 1-5 ratio, based on age, gender, year of diagnosis, cancer type and disease stage. Outpatient and inpatient HES data up to six-months from diagnosis were costed using NHS Reference costs and inflated to 2017/2018 costs.
879 prison and 4326 general population cancer diagnoses were identified in HES. The adjusted six-month cost of cancer care was significantly lower for people in prison (-£1216.95% confidence interval (CI) -1638 to -795), driven by fewer outpatient attendances. However, people diagnosed in prison had higher emergency care costs (£497.95% CI 375-619). Security escorts further increased the total cost of care.
Following a cancer diagnosis, people in English prisons have significantly lower planned care costs, but higher emergency care costs and an overall higher cost due to security escorts. Further work is required to identify ways of improving cancer care for people in prisons to ensure it is equivalent to that received by the general population.
National Institute for Health and Social Care Research 16/52/53.
与普通人群中的同龄人相比，监狱中的人身心健康状况较差。其原因是多方面的，从生活方式因素到获得医疗保健的机会较少。关于监狱中的人患癌症的情况以及他们的护理成本与普通人群相比如何，人们知之甚少。
在国家癌症登记数据集中确定了在英国监狱中被诊断患有癌症的人员的数据，并将其与2012 - 2017年的医院 Episode 统计数据（HES）相关联。根据年龄、性别、诊断年份、癌症类型和疾病阶段，使用1:5的比例确定了普通人群匹配患者。使用NHS参考成本对诊断后长达六个月的门诊和住院HES数据进行成本核算，并将其通胀至2017/2018年成本。
在HES中确定了879例监狱癌症诊断病例和4326例普通人群癌症诊断病例。由于门诊就诊次数较少，监狱中的人癌症护理的调整后六个月成本显著较低（-1216.95英镑，95%置信区间（CI）-1638至-795）。然而，在监狱中被诊断出的人急诊护理成本较高（497.95英镑，95%CI 375 - 619）。安全护送进一步增加了护理总成本。
在被诊断患有癌症后，英国监狱中的人计划护理成本显著较低，但急诊护理成本较高，并且由于安全护送总体成本更高。需要进一步开展工作，以确定改善监狱中人员癌症护理的方法，以确保其与普通人群所接受护理相当。
国家卫生与社会保健研究所16/52/53。
