The Association of Hematological Malignancy and End-of-Life Expenditure in Cancer Decedents
The Association of Hematological Malignancy and End-of-Life Expenditure in Cancer Decedents
复制标题
血液恶性肿瘤与癌症死者临终支出的关联
作者：
Yeh;Chih;Chun;Ching‐Chih Lee
摘要在台湾全民健康保险的总预算中，癌症病患的支出有显著的成长。本研究旨在探讨恶性血液病患者在生命最后6个月内的医疗费用是否与其生命末期的医疗费用有关，我们使用台湾NHI研究数据库中的数据进行回顾性队列研究和基于人群的研究。2009年至2011年，42，754例癌症患者入组研究了终末期护理医疗费用的决定因素。癌症患者在生命最后6个月内终末期护理的平均医疗费用为12，965 ± 10，959美元（平均值±标准差）（所有费用均以美元表示）。 急性白血病和淋巴瘤患者比非血液系统恶性肿瘤患者分别多花费16,934美元和7840美元（P <0.001）。 恶性血液病患者诊断后生存期>6个月、6 ~ 12个月和>12个月的医疗费用均显示急性白血病和淋巴瘤的医疗费用高于其他疾病（P <0.001）。 急性白血病、淋巴瘤和非血液系统恶性肿瘤患者的主治医师专业差异有统计学意义，急性白血病和淋巴瘤患者的医疗费用高于非血液系统恶性肿瘤患者。应进一步研究急性白血病的治疗策略，以节省卫生保健预算。
AbstractWithin the overall National Health Insurance (NHI) budget in Taiwan, there has been a remarkable increase in expenditure for cancer patients. This study was designed to explore whether hematological malignancy is associated with higher end-of-life (EOL) medical expenditure in their last 6 months of life.We used data from the Taiwan NHI Research Database to do a retrospective cohort and population-based study. There were 42,754 cancer patients enrolled in order to study the determinants of medical expenditure for EOL care from 2009 to 2011.The mean medical expenditure for EOL care for cancer patients in the last 6 months of life was $12,965 ± 10,959 (mean ± standard deviation ) (all costs are given in US dollars). Patients with acute leukemia and lymphoma had an additional cost of $16,934 and $7840 than those with nonhematological malignancy (P < 0.001). Medical expenditures for cancer patients with a hematological malignancy and postdiagnosis survival of >6 months, between 6 and 12 months, and >12 months all showed that acute leukemia and lymphoma accounted for more medical expenditure than did others (P < 0.001). The primary physician's specialty between acute leukemia, lymphoma, and nonhematological malignancy patients had statistically difference.The medical expenditure of cancer patients in acute leukemia and lymphoma was more than nonhematological malignancy. Treatment strategies for acute leukemia should be studied further in order to save the health care budget.