Patient and oncologist discussions about cancer care costs
Patient and oncologist discussions about cancer care costs
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DOI：
10.1007/s00520-013-2050-x
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发表时间：
2014-04-01
影响因子：
3.1
通讯作者：
Buist, Diana S. M.
中科院分区：
文献类型：
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作者：
Henrikson, Nora B.;Tuzzio, Leah;Buist, Diana S. M.
癌症护理的患者自付费用高于任何其他卫生保健部门。肿瘤学家和患者之间关于成本的讨论还没有得到很好的理解。我们进行了一项探索性访谈研究，以检查患者和提供者讨论治疗费用的频率，模式，态度和偏好。我们对肿瘤临床医生和大型非营利性医疗系统接受化疗的人进行了半结构化的电话访谈。多位研究者使用改良内容分析法、扎根理论及互动分析法进行主题分析，病患主题包括成本与其经验的相关性、偏好以医生作为成本讨论的起点，但相对较少与医生或其他照护团队成员讨论。提供者的主题是强调临床效益高于成本，坚信成本相关的决定应该与患者，缺乏获得治疗费用。讨论成本的兴趣和获取成本信息的障碍是患者和提供者的共同主题。医生和患者希望讨论治疗成本，但无法获得这些信息。这些数据支持越来越多的证据表明，提供者在癌症治疗计划的成本讨论中发挥作用。
Patient out-of-pocket costs are higher for cancer care than for any other health-care sector. Oncologist-patient discussions of costs are not well understood. We conducted an exploratory interview study to examine the frequency, patterns, attitudes, and preferences of both patients and providers on discussion of treatment costs.We conducted semi-structured telephone interviews with oncology clinicians and people receiving chemotherapy at a large nonprofit health system. Multiple investigators conducted thematic analysis using modified content analysis, grounded theory, and interaction analysis methods.Patient themes included the relevance of cost to their experience, preference for the doctor to be the starting point of cost discussions, but relative infrequency of discussions with doctors or other care team member. Provider themes were an emphasis on clinical benefit above costs, conviction that cost-related decisions should rest with patients, and lack of access to treatment costs. Interest in discussing costs and barriers accessing cost information were common themes from both patients and providers.Doctors and patients want to discuss treatment costs but lack access to them. These data support growing evidence for a provider role in discussions of cost during cancer treatment planning.