Nagel E, Meyer zu Vilsendorf A, Obermann K
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:91-7.
Economic aspects of medical care play an increasingly more important part in evaluation of diagnostics and therapeutics. Therefore it seems necessary to examine the present studies and their results carefully. In meta-analysis of cancer care, different techniques of economic analysis are used. Stage-specific analyses of direct costs in patients with colorectal neoplasms show a major influence of the stage at diagnosis on total costs of initial care. In contrast to this, increased age and increased comorbidity of patients did not function as a cost increasing factor in each stage of the disease. Net costs, that is attributable costs, are the difference between costs of the care of each subject and the average costs of controls. Net costs of continuing care decreased with age in patients with colorectal neoplasms. Cost-effectiveness analyses in patients with colon and breast cancers demonstrated lower medicare payments per year of survival for tumors diagnosed at earlier stages. From the date presented, no relevance of health economic aspects on individual planning of therapy can be deduced. Health economic aspects are appropriate in order to develop guidelines and are a basis of discussion at the level of macro-allocation. They can be used in the scope of a multi-dimensional evaluation of a new treatment and serve medical and therapeutic definitions of goals.
医疗保健的经济因素在诊断和治疗评估中发挥着越来越重要的作用。因此，仔细审视当前的研究及其结果似乎很有必要。在癌症护理的荟萃分析中，采用了不同的经济分析技术。对结直肠肿瘤患者直接成本的阶段特异性分析表明，诊断阶段对初始护理的总成本有重大影响。与此相反，患者年龄的增加和合并症的增加在疾病的每个阶段都不是成本增加的因素。净成本，即可归因成本，是每个受试者的护理成本与对照组平均成本之间的差额。结直肠肿瘤患者持续护理的净成本随年龄增长而降低。对结肠癌和乳腺癌患者的成本效益分析表明，早期诊断的肿瘤每生存一年的医疗保险支付较低。根据所提供的数据，无法推断出健康经济因素与个体治疗规划的相关性。健康经济因素适用于制定指南，是宏观分配层面讨论的基础。它们可用于对新治疗进行多维度评估的范围，并服务于医疗和治疗目标的定义。
