Richards M A, Braysher S, Gregory W M, Rubens R D
ICRF Clinical Oncology Unit, Guy's Hospital, London, UK.
Br J Cancer. 1993 Apr;67(4):856-60. doi: 10.1038/bjc.1993.157.
Little information is currently available on the use of hospital resources and the resulting costs of treating any advanced cancer. Such data may be useful for planning purposes and for calculating the cost effectiveness of measures designed to reduce the incidence of advanced disease (such as the National Breast Screening Programme). A retrospective analysis of the medical records of 50 patients with advanced breast cancer who attended the Guy's Hospital Oncology Unit and who died between October 1988 and December 1990 has therefore been undertaken. For each patient, the duration of in-patient stays and principal indications for admissions were recorded, together with the number of out-patient attendances. Details of endocrine treatment, chemotherapy and radiotherapy were abstracted as were all radiological and laboratory investigations. Costs for each of these activities were calculated. The median duration of advanced disease was 17 months (mean 27 months; range 7 days-12 years). The mean cost of treatment per patients was calculated to be 7,620 pounds (range 317 pounds-27,860 pounds). Mean duration of in-patient stay was 32 days (0-133) and this accounted for 56% of total costs. The large majority (> 80%) of the time spent as an in-patient was for the care of serious illness rather than for specific antitumour treatment. Cytotoxic drugs accounted for 9% of the total cost, compared with 8% for radiotherapy and 13% for laboratory and radiological investigations.
目前关于医院资源的使用以及治疗任何晚期癌症所产生的费用的信息很少。这些数据可能对规划目的以及计算旨在降低晚期疾病发病率的措施（如国家乳腺癌筛查计划）的成本效益有用。因此，对1988年10月至1990年12月期间在盖伊医院肿瘤科就诊并死亡的50例晚期乳腺癌患者的病历进行了回顾性分析。记录了每位患者的住院时间和主要入院指征，以及门诊就诊次数。提取了内分泌治疗、化疗和放疗的详细信息，以及所有的放射学和实验室检查。计算了这些活动中每一项的费用。晚期疾病的中位持续时间为17个月（平均27个月；范围7天至12年）。每位患者的平均治疗费用计算为7620英镑（范围317英镑至27860英镑）。平均住院时间为32天（0至133天），这占总费用的56%。住院时间的绝大多数（>80%）用于重病护理而非特定的抗肿瘤治疗。细胞毒性药物占总费用的9%，放疗占8%，实验室和放射学检查占13%。
