Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
复制标题
评估实现“健康人民 2020”减少侵袭性结直肠癌这一目标的健康效益和成本节约。
DOI：
10.1016/j.ypmed.2017.09.022
复制
发表时间：
2018
影响因子：
5.1
通讯作者：
Chang,Su-Hsin
中科院分区：
文献类型：
--
作者：
Hung,Mei-Chuan;Ekwueme,DonatusU;White,Arica;Rim,SunHee;King,JessicaB;Wang,Jung-Der;Chang,Su-Hsin
这项研究旨在量化如果达到健康人群2020目标，将浸润性结直肠癌（CRC）发病率降低15%，则节省的总潜在生命年（LY）和医疗保健成本节省。我们从全国代表性的癌症数据集中确定了2001年至2011年间诊断为侵袭性CRC的患者（n= 886，380）。我们根据性别、种族/民族和年龄对这些患者进行分层。使用这些数据和2001-2011年美国生命表的数据，我们估计了每个CRC组和相应参考组的生存函数，并计算了保存的人均LY。我们使用2008-2012年医疗支出小组调查估计了每人每年的医疗成本节省。我们通过将减少的CRC患者数量分别乘以每人节省的LY和终身医疗保健成本节省来计算节省的LY和成本节省。我们估计，男性和女性分别节省了84，569和64，924个LY，分别节省了3.293亿美元和2.942亿美元的医疗成本（以2013年美元计算）。我们估计，男性和女性患CRC的人每人可节省6.3个潜在的LY，男性可节省24，000美元的医疗费用，女性可节省28，000美元的医疗费用。非西班牙裔白人和年龄在60-64岁的人有最高的总潜在LY节省和成本节省。实现HP 2020目标，即到2020年将侵袭性CRC发病率降低15%，将可能节省近15万生命年和6.24亿美元的医疗费用。
This study aims to quantify the aggregate potential life-years (LYs) saved and healthcare cost-savings if the Healthy People 2020 objective were met to reduce invasive colorectal cancer (CRC) incidence by 15%. We identified patients (n= 886,380) diagnosed with invasive CRC between 2001 and 2011 from a nationally representative cancer dataset. We stratified these patients by sex, race/ethnicity, and age. Using these data and data from the 2001–2011 U.S. life tables, we estimated a survival function for each CRC group and the corresponding reference group and computed per-person LYs saved. We estimated per-person annual healthcare cost-savings using the 2008–2012 Medical Expenditure Panel Survey. We calculated aggregate LYs saved and cost-savings by multiplying the reduced number of CRC patients by the per-person LYs saved and lifetime healthcare cost-savings, respectively. We estimated an aggregate of 84,569 and 64,924 LYs saved for men and women, respectively, accounting for healthcare cost-savings of $329.3 and $294.2 million (in 2013$), respectively. Per person, we estimated 6.3 potential LYs saved related to those who developed CRC for both men and women, and healthcare cost-savings of $24,000 for men and $28,000 for women. Non-Hispanic whites and those aged 60–64 had the highest aggregate potential LYs saved and cost-savings. Achieving the HP2020 objective of reducing invasive CRC incidence by 15% by year 2020 would potentially save nearly 150,000 life-years and $624 million on healthcare costs.