Reducing the cost of cancer care: how to bend the curve downward.
Reducing the cost of cancer care: how to bend the curve downward.
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DOI：
10.14694/edbook_am.2012.32.e46
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发表时间：
2012-01-01
期刊：
影响因子：
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通讯作者：
Kelly, Ronan J
中科院分区：
文献类型：
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作者：
Smith, Thomas J;Hillner, Bruce E;Kelly, Ronan J
医疗保健和癌症护理费用正在不可持续地上涨，保险费用在10年内翻了一番。肿瘤学家发现自己既是高成本的受害者，也是我们做什么和不做什么的高成本护理的原因。我们之前概述了肿瘤学家可以亲自弯曲成本曲线向下的五种方式，以及需要改变以降低成本的五种社会态度。在这里，我们提出了一些实际的方法来降低成本，同时保持或提高质量，包括：1）循证治疗后的监测; 2）减少使用白色细胞刺激因子（非格司亭和培非格司亭）; 3）更好地将姑息治疗纳入常规肿瘤治疗;和4）使用循证的，成本意识的临床路径，允许适当的护理，并导致相同或更好的结果，降低三分之一的成本。
Health care and cancer care costs are rising unsustainably such that insurance costs have doubled in 10 years. Oncologists find themselves both victims of high costs and the cause of high-cost care by what we do and what we do not do. We previously outlined five ways that oncologists could personally bend the cost curve downward and five societal attitudes that would require change to lower costs. Here, we present some practical ways to reduce costs while maintaining or improving quality, including: 1) evidence-based surveillance after curative therapy; 2) reduced use of white cell stimulating factors (filgrastim and pegfilgrastim); 3) better integration of palliative care into usual oncology care; and 4) use of evidence-based, cost-conscious clinical pathways that allow appropriate care and lead to equal or better outcomes at one-third lower cost.