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[外科医疗保健模式与癌症成本:两项利用人口登记数据的研究]

[Surgical health care patterns and cancer cost: two studies using population registry data].

作者信息

Schraub S, Arveux P, Mercier M, Gauthier M

机构信息

Registre des Tumeurs du Doubs, Besançon.

出版信息

Rev Epidemiol Sante Publique. 1996;44 Suppl 1:S33-9.

PMID:8935862
Abstract

The goal of the first study was to analyze the surgical health care patterns for operated cases colorectal cancer. The role of surgery was analyzed for 732 cases diagnosed between 1988 and 1991 and recorded by the Doubs Cancer Registry, France. Young patients were more inclined to surgery than the older patients: 41% before 65 years and 27% after 65 (p < 0.02). Age was the only variable related to the type of activity of the surgeon (public or private sector): 65.9% of patients younger than 65 years were treated by a private surgeon but only 56.6% of patients older than 65 (p < 0.02). The goal of the second study was to analyze direct costs induced by cancer from the point of view of the "Mutualité Sociale Agricole", the rural branch of the French Social Security. A 3-year follow-up was the minimum required to be able to isolate costs in function of the different clinical steps of the disease. This study was performed on 24 breast cancers, 16 lung cancers, 22 prostatic cancers and 36 colorectal cancers diagnosed between 1988 and 1991 in patients insured by the Doubs MSA (the rural branch of the French Social Security). The average cost of a cancer varied from 53,800 FF to 82,600 FF, according to cancer site. Transportation costs represented from 7% to 15% of the total cost. These two studies outline the usefulness of cancers registries as a tool for health authorities looking for a better efficiency of the health care system.

摘要

第一项研究的目的是分析接受手术治疗的结直肠癌病例的外科医疗模式。对1988年至1991年间法国杜省癌症登记处记录的732例确诊病例的手术作用进行了分析。年轻患者比老年患者更倾向于接受手术:65岁之前为41%,65岁之后为27%(p<0.02)。年龄是与外科医生的活动类型(公立或私立部门)相关的唯一变量:65岁以下患者中有65.9%由私立外科医生治疗,但65岁以上患者中只有56.6%(p<0.02)。第二项研究的目的是从法国社会保障农村分支机构“农业社会互助会”的角度分析癌症引发的直接费用。至少需要3年的随访才能根据疾病的不同临床阶段分离费用。这项研究针对的是1988年至1991年间在杜省农业社会互助会(法国社会保障农村分支机构)参保的患者中诊断出的24例乳腺癌、16例肺癌、22例前列腺癌和36例结直肠癌。根据癌症部位的不同,一种癌症的平均费用从53800法郎到82600法郎不等。交通费用占总费用的7%至15%。这两项研究概述了癌症登记处作为卫生当局提高医疗保健系统效率工具的有用性。

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