Unlocking the Economics of Cancer Control in Uganda Using KeyScope

项目总结/摘要 本申请是根据特别利益通知（NOSI）提交的。 标识为“NOT-CA-23-052。手术是癌症治疗的基础，但患者在 低收入和中等收入国家（LMIC）的手术机会有限，部分原因是 无法获得设备和大量的自付（OOP）医疗费用。估计 中低收入国家有3300万人面临与直接疾病有关的灾难性卫生支出。 OOP手术费用。在这种情况下，保护家庭免受CHE已成为一种 主要政策目标，世界银行和世卫组织制定了100%保护免受 由于OOP付款而产生的财务困难。腹腔镜（锁孔）手术具有 有可能提供针对CHE的保护，是高收入国家的标准护理 用于胸部和腹部的许多癌症切除术。它避免了大切口， 通过微小切口操作的摄像机和仪器，因此优点包括： 更小的切口，减少疼痛，改善恢复时间，最大限度地减少术后感染， 缩短住院时间，降低CHE。我们在乌干达的团队开发了一种低成本， 耐用的腹腔镜系统（KeyScope）通过独特的多学科 协作拟议的项目旨在衡量由于OOP成本造成的CHE风险， 在乌干达癌症中心寻求胸部和腹部癌症手术治疗的个人 制定并衡量使用KeyScope与标准护理（开放式）的成本效益 手术）在需要手术的癌症患者的模拟队列中进行。在我们目前的U 01 在这项研究中，我们正在乌干达癌症研究所进行KeyScope的首次人体研究。 拟议的研究是本项目的直接延伸，将通过以下方式补充U 01 测量KeyScope在同一癌症患者人群中的经济影响， 乌干达癌症研究所

PROJECT SUMMARY / ABSTRACT This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA-23-052. Surgery is the foundation of cancer treatment, but patients in low- and middle-income countries (LMICs) have limited surgical access due in part to inaccessibility of equipment and substantial out-of-pocket (OOP) healthcare costs. An estimated 33 million individuals in LMICs face catastrophic health expenditures (CHE) related to direct OOP surgical costs. In this context, household protection against CHE has emerged as a leading policy goal, with the World Bank and WHO setting targets of 100% protection from financial hardships arising from OOP payments. Laparoscopic (keyhole) surgery has the potential to provide protection against CHE and is the standard of care in high-income countries for many cancer excisions in the chest and abdomen. It avoids large incisions by using a camera and instruments manipulated through tiny incisions, and therefore advantages include: smaller incisions, decreased pain, improved recovery time, minimized post-surgical infections, and shorter hospital stays, reducing CHE. Our team in Uganda has developed a low-cost, durable laparoscopic system (KeyScope) for use in LMICs through a unique multi-disciplinary collaboration. The proposed project aims to measure the risk of CHE due to OOP costs among individuals seeking surgical care for cancers in the chest and abdomen at the Uganda Cancer Institute and measure the cost-benefit of using KeyScope versus the standard of care (open surgery) among a simulated cohort of patients with cancer needing surgery. In our current U01 study, we are performing a First-In-Human study of KeyScope at the Uganda Cancer Institute. The proposed study is a direct extension of this project and will complement the U01 by measuring the economic impact of KeyScope within the same population of cancer patients at the Uganda Cancer Institute.