Phase-specific and lifetime costs of cancer care in Ontario, Canada
Phase-specific and lifetime costs of cancer care in Ontario, Canada
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DOI：
10.1186/s12885-016-2835-7
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发表时间：
2016-10-18
期刊：
影响因子：
3.8
通讯作者：
Krahn, Murray D.
中科院分区：
文献类型：
--
作者：
de Oliveira, Claire;Pataky, Reka;Krahn, Murray D.
背景：癌症是一个重大的公共卫生问题，对全世界的卫生保健系统来说是一个重大的经济负担。本分析的目的是估计加拿大安大略21个最常见癌症部位和其余肿瘤部位的特定阶段、5年和终生净成本。方法：我们选择了1997年至2007年期间诊断为原发性癌症的所有成年患者，这些患者具有有效的ICD-0网站和组织学代码，并且在诊断后存活30天或更长时间，来自安大略癌症登记处（N = 394，092）。患者与来自安大略癌症护理和临床和评估科学研究所的行政卫生保健数据库的治疗数据相关联。净费用（即，患者和匹配的非癌症对照受试者之间的成本差异）估计的阶段的护理和性别，并用于估计5年和终身costs.Results：平均净成本的护理（2009年CAD）是最高的初始（6个月后诊断）和终端（12个月前死亡）阶段，最低的（3个月）诊断前和继续阶段的护理。特定阶段的净成本一般最低的黑色素瘤和最高的脑癌。平均5年净成本从黑色素瘤、甲状腺和睾丸癌的不到25，000美元到多发性骨髓瘤和白血病的超过60，000美元不等。终生成本范围从肺癌和肝癌不到55，000美元到白血病，多发性骨髓瘤，淋巴瘤和乳腺癌超过110，000美元。结论：癌症护理的成本是巨大的，并因癌症部位，护理阶段和分析的时间范围而异。这些成本估计对决策者了解癌症护理的经济负担是有价值的，并且可能是进行癌症相关经济评估的研究人员的有用输入。
Background: Cancer is a major public health issue and represents a significant economic burden to health care systems worldwide. The objective of this analysis was to estimate phase-specific, 5-year and lifetime net costs for the 21 most prevalent cancer sites, and remaining tumour sites combined, in Ontario, Canada.Methods: We selected all adult patients diagnosed with a primary cancer between 1997 and 2007, with valid ICD-O site and histology codes, and who survived 30 days or more after diagnosis, from the Ontario Cancer Registry (N = 394,092). Patients were linked to treatment data from Cancer Care Ontario and administrative health care databases at the Institute for Clinical and Evaluative Sciences. Net costs (i.e., cost difference between patients and matched non-cancer control subjects) were estimated by phase of care and sex, and used to estimate 5-year and lifetime costs.Results: Mean net costs of care (2009 CAD) were highest in the initial (6 months post-diagnosis) and terminal (12 months pre-death) phases, and lowest in the (3 months) pre-diagnosis and continuing phases of care. Phase-specific net costs were generally lowest for melanoma and highest for brain cancer. Mean 5-year net costs varied from less than $25,000 for melanoma, thyroid and testicular cancers to more than $60,000 for multiple myeloma and leukemia. Lifetime costs ranged from less than $55,000 for lung and liver cancers to over $110,000 for leukemia, multiple myeloma, lymphoma and breast cancer.Conclusions: Costs of cancer care are substantial and vary by cancer site, phase of care and time horizon analyzed. These cost estimates are valuable to decision makers to understand the economic burden of cancer care and may be useful inputs to researchers undertaking cancer-related economic evaluations.