Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan.
Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan.
复制标题
DOI：
10.1186/s12913-016-1854-z
复制
发表时间：
2016-10-21
影响因子：
2.8
通讯作者：
Tanaka T
中科院分区：
文献类型：
--
作者：
Maeda E;Higashi T;Hasegawa T;Yokoya S;Mochizuki T;Ishii T;Ito J;Kanzaki S;Shimatsu A;Takano K;Tajima T;Tanaka H;Tanahashi Y;Teramoto A;Nagai T;Hanew K;Horikawa R;Yorifuji T;Wada N;Tanaka T
在日本，如果儿童符合临床标准，包括身高限制（男孩：156.4 cm;女孩：145.4 cm），则生长激素（GH）缺乏症儿童的治疗费用由政府补贴。然而，一些资助计划，如地方政府提供的补贴，可以用于那些谁超过高度限制。在这项研究中，我们探讨了财政支持GH治疗使用这种自然分配的影响。对696例达到身高限制的青少年患者（451例男孩和245例女孩）进行了回顾性分析。经济支持和继续治疗之间的关系进行了评估，采用多元逻辑回归分析调整年龄，性别，身高，生长速度，骨龄和不良反应。在分析的696名儿童中，108名（15. 5%）仍有资格获得财政支持。有资格获得支持的儿童中继续GH治疗的比例高于无资格获得支持的儿童（75.9% vs. 52.0%，P < 0.001）。在调整人口统计学特征和临床因素后，男孩和女孩的经济支持继续治疗的比值比分别为4.04（95%置信区间[CI]：1.86-8.78）和1.72（95% CI：0.80-3.70）。财政支持影响GH缺乏症儿童继续治疗的决定。在获得财政支助的资格方面的地域差异构成了一个需要政策关注的道德问题。应探讨在用于继续治疗的公共开支与由此提高生活质量之间的适当平衡。
Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys: 156.4 cm; girls: 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation. A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects. Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P < 0.001). The odds ratios of financial support to continuing treatment were 4.04 (95 % confidence interval [CI]: 1.86–8.78) in boys and 1.72 (95 % CI: 0.80–3.70) in girls, after adjusting for demographic characteristics and clinical factors. Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.
登录
查看更多内容
DOI：
10.1098/rspb.2002.2111
发表时间：
2002-09-22
影响因子：
4.7
作者：
Nettle, D
通讯作者：
Nettle, D
影响因子：
3.8
作者：
Borrás Pérez V;López-Siguero JP;Martínez G;Corripio R;Fernández JM;Labarta JI;Ferrer M;Cabrinety N;Prieto P;Ramón-Krauel M;Bosch J;Espino R;Palla Garcia M;Rebollo FJ
通讯作者：
Rebollo FJ
影响因子：
64.8
作者：
Pawlowski, B;Dunbar, RIM;Lipowicz, A
通讯作者：
Lipowicz, A
影响因子：
3.2
作者：
Chaplin, John Eric;Kristrom, Berit;Albertsson-Wikland, Kerstin
通讯作者：
Albertsson-Wikland, Kerstin
影响因子：
17.7
作者：
Magnusson, PKE;Gunnell, D;Rasmussen, F
通讯作者：
Rasmussen, F