Evaluating the supportive care costs of severe radiochemotherapy-induced mucositis and pharyngitis - Results from a Northwestern University costs of cancer program pilot study with head and neck and nonsmall cell lung cancer patients who received care at a county hospital, a Veterans Administration Hospital, or a comprehensive cancer care center
Evaluating the supportive care costs of severe radiochemotherapy-induced mucositis and pharyngitis - Results from a Northwestern University costs of cancer program pilot study with head and neck and nonsmall cell lung cancer patients who received care at a county hospital, a Veterans Administration Hospital, or a comprehensive cancer care center
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DOI：
10.1002/cncr.23714
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发表时间：
2008-09-15
期刊：
影响因子：
6.2
通讯作者：
Bennett, Charles L.
中科院分区：
文献类型：
--
作者：
Nonzee, Narissa J.;Dandade, Neal A.;Bennett, Charles L.
背景。很少有研究调查头颈癌 (HNC) 或肺癌患者中放化疗引起的粘膜炎/咽炎的支持治疗费用，尽管这些并发症有负面的临床影响。方法。作者确定了一个回顾性队列，其中包括在芝加哥 3 家医院（退伍军人管理局医院、县医院或三级医院）中的 1 家接受过放化疗的 HNC 或非小细胞肺癌 (NSCLC) 患者。检查图表是否存在严重粘膜炎/咽炎以及所使用的医疗资源。资源估算被转换为从标准来源（医院山、医疗保险医生费用表、红皮书）获得的成本单位。对发生严重粘膜炎/咽炎和未发生严重粘膜炎/咽炎的患者所使用的资源和直接医疗费用进行了估计。结果。放化疗期间，99 例 HNC 患者中 70.1% 发生严重粘膜炎/咽炎，40 例 NSCLC 患者中 37.5% 发生严重粘膜炎/咽炎。对于患有粘膜炎/咽炎的患者，每位患者的总医疗费用中位数为 39,313 美元，对于没有粘膜炎/咽炎的患者，每位患者的总医疗费用中位数为 20,798 美元 (P =.007)。延长住院时间导致医疗费用增加 12,600 美元（患有严重粘膜炎/咽炎的中位数为 14 天 [19,600 美元]，而没有严重粘膜炎/咽炎则为 5 天 [7000 美元]：P = .017）。对于患有粘膜炎/咽炎的 HNC 患者，增量住院费用为 14,000 美元，总医疗费用为 517,244。对于患有粘膜炎/咽炎的 NSCLC 患者，这些费用分别为 11,200 美元和 25,000 美元。结论。在目前的研究中，接受放化疗的 HNC 和 NSCLC 患者中，出现严重粘膜炎/咽炎的患者的医疗费用高于未接受放化疗的患者。
BACKGROUND. Few studies have examined the costs of supportive care for radiochemotherapy-induced mucosits/pharyngitis among patients with head and neck cancer (HNC) or lung cancers despite the documented negative clinical impact of these complications.METHODS. The authors identified a retrospective cohort of patients with HNC or nonsmall lung cancer (NSCLC) who had received radiochemotherapy at 1 of 3 Chicago hospitals (a Veterans Administration hospital, a county hospital, or a tertiary care hospital). Charts were reviewed for the presence/absence of severe mucositis/pharyngitis and the medical resources that were used. Resource estimates were converted into cost units obtained from standard sources (hospital hills, Medicare physician fee schedule, Red Book). Estimates of resources used and direct medical costs were compared for patients who did and patients who did not develop severe mucositis/pharyngitis.RESULTS. Severe mucositis/pharyngitis occurred in 70.1% of 99 patients with HNC and in 37.5% of 40 patients with NSCLC during radiochemotherapy. The total median medical costs per patient were $39,313 for patients with mucositis/pharyngitis and $20,798 for patients without mucositis/pharyngitis (P =.007). Extended inpatient hospitalization accounted for $12,600 of the increased medical costs (median 14 clays [$19,600] with severe mucositis/pharyngitis vs 5 days [$7000] without: P = .017). For patients who had HNC with murcositis/pharyngitis, incremental inpatient hospitalization costs were $14,000, and total medical costs were 517,244. For patients who had NSCLC with In mucositis/pharyngitis, these costs were $11,200 and $25,000, respectively.CONCLUSIONS. In the current study, the medical costs among the patients with HNC and NSCLC who received radiochemotherapy were greater for those who developed severe mucositis/pharyngitis than for those who did not.