Legorreta A P, Brooks R J, Leibowitz A N, Solin L J
Health Net, Woodland Hills, Calif, USA.
Arch Intern Med. 1996 Oct 28;156(19):2197-201.
To determine the longitudinal cost of the treatment of patients with breast cancer.
An analysis was performed of 200 women with 205 newly diagnosed breast cancers during 1989 in a health maintenance organization population (US Healthcare, Blue Bell, Pa). Medical records and claims data were analyzed for the total costs of medical care during the 4-year period after diagnosis. The costs over time were analyzed for clinical stage and use of mammography screening.
The total costs of medical care during the 4-year period after diagnosis were strongly related to clinical stage at diagnosis, with higher total costs for patients with stages III to IV at diagnosis compared with patients with stages 0 to II at diagnosis. The cost for all stages of disease declined after years 1 to 2, with the exception of stage II, which increased slightly in years 3 to 4. The use of screening mammography was associated with a significant decrease in the cost of medical care during the 4-year study period.
The goal of mammography screening programs should be to achieve downstaging to stages 0 to 1 to achieve reduction in breast cancer mortality and to reduce the overall consumption of health care resources for the treatment of breast cancer. These cost data should be considered within the framework of future cost-effective analysis for screening mammography programs.
确定乳腺癌患者治疗的纵向成本。
对1989年在一家健康维护组织人群(美国医疗保健公司,宾夕法尼亚州蓝铃市)中200名患有205例新诊断乳腺癌的女性进行了分析。分析了医疗记录和理赔数据,以获取诊断后4年期间的医疗总费用。对随时间变化的成本进行了分析,以了解临床分期和乳房X线筛查的使用情况。
诊断后4年期间的医疗总费用与诊断时的临床分期密切相关,诊断为III至IV期的患者的总费用高于诊断为0至II期的患者。除II期外,疾病各阶段的费用在第1至2年后均下降,II期在第3至4年略有增加。在4年的研究期间,乳房X线筛查的使用与医疗费用的显著降低相关。
乳房X线筛查计划的目标应该是实现降期至0至I期,以降低乳腺癌死亡率,并减少治疗乳腺癌的医疗保健资源的总体消耗。这些成本数据应在未来乳房X线筛查计划的成本效益分析框架内予以考虑。