Background: Uterine cervical cancer (UCC) represents a public health problem in many part of the world. The use of new technologies is leading to increased treatment costs, resulting in a substantial economic impact w...Background: Uterine cervical cancer (UCC) represents a public health problem in many part of the world. The use of new technologies is leading to increased treatment costs, resulting in a substantial economic impact worldwide. Standardization of economic evaluation methods is needed to improve comparisons between jurisdictions. Objective: To identify the methods used to measure the cost of treating invasive UCC, and to search for correlations between cancer treatment expenditures and local economies. Methods: We searched articles in MEDLINE, LILACS, and SciELO with no language restrictions, and included publications from January 01, 2007 to December 31, 2016. Studies were included if they described the annual direct cost of invasive cervical cancer and detailed the costing method. Complete economic evaluations were excluded. Results were described in 2016 international dollars. Results: Of 1581 studies initially reviewed, 13 articles were included in the analysis. Six articles used a bottom-up;six used a top-down approach and one used both. Annual cost per patient varied from I$ 2146.22 (Poland) to 34,351.54 (Sweden). Middle-income countries (MIC) spent median 72.52% of its GDP per capita on the treatment of invasive cervical cancer, while high-income countries (HIC) spent median 30.12% (p = 0.032). No significant difference was found when separated by costing method. Conclusions: We found that, for the treatment costs of invasive UCC, the percentages of GDP per capita were statistically higher in MIC than in HIC. However, no significant difference was found between costing methods, and the top-down approach could be used.展开更多
目的对比福建医科大学附属第二医院脑出血患者在实行疾病诊断相关分组(diagnosis related groups,DRG)支付方式前后的住院费用,并分析其影响因素,为有效调整区域化DRG费用标准提供参考依据。方法本研究以福建医科大学附属第二医院2021年...目的对比福建医科大学附属第二医院脑出血患者在实行疾病诊断相关分组(diagnosis related groups,DRG)支付方式前后的住院费用,并分析其影响因素,为有效调整区域化DRG费用标准提供参考依据。方法本研究以福建医科大学附属第二医院2021年9月—2023年6月病案首页诊断编码(疾病分类代码国临版2.0)为I60~I62的病例为研究对象,采用Kendall相关性分析进行单因素分析,将差异有统计学意义的变量纳入多元线性回归模型进行多因素分析。结果实行DRG支付费改革后,脑出血住院患者平均住院费用与自付金额分别下降26.17%和45.55%,控费效果较好;DRG支付方式下对住院费用影响最大的前4位因素是住院天数、是否手术、出院时已治愈以及住院时病重状态;DRG支付方式下,脑出血相关DRG分组呈盈利状态。结论DRG支付方式有效实现控费目标,改革成效明显;医疗机构应注意缩短住院天数,合理提高体现医疗价值的治疗费用占比,减少不必要的医药、耗材、检查等支出;医保部门应考虑将住院天数纳入DRG分组标准,综合考虑医疗服务质量、医保支付能力、患者个人经济负担,动态调整DRG分组支付标准。展开更多
文摘Background: Uterine cervical cancer (UCC) represents a public health problem in many part of the world. The use of new technologies is leading to increased treatment costs, resulting in a substantial economic impact worldwide. Standardization of economic evaluation methods is needed to improve comparisons between jurisdictions. Objective: To identify the methods used to measure the cost of treating invasive UCC, and to search for correlations between cancer treatment expenditures and local economies. Methods: We searched articles in MEDLINE, LILACS, and SciELO with no language restrictions, and included publications from January 01, 2007 to December 31, 2016. Studies were included if they described the annual direct cost of invasive cervical cancer and detailed the costing method. Complete economic evaluations were excluded. Results were described in 2016 international dollars. Results: Of 1581 studies initially reviewed, 13 articles were included in the analysis. Six articles used a bottom-up;six used a top-down approach and one used both. Annual cost per patient varied from I$ 2146.22 (Poland) to 34,351.54 (Sweden). Middle-income countries (MIC) spent median 72.52% of its GDP per capita on the treatment of invasive cervical cancer, while high-income countries (HIC) spent median 30.12% (p = 0.032). No significant difference was found when separated by costing method. Conclusions: We found that, for the treatment costs of invasive UCC, the percentages of GDP per capita were statistically higher in MIC than in HIC. However, no significant difference was found between costing methods, and the top-down approach could be used.
文摘目的对比福建医科大学附属第二医院脑出血患者在实行疾病诊断相关分组(diagnosis related groups,DRG)支付方式前后的住院费用,并分析其影响因素,为有效调整区域化DRG费用标准提供参考依据。方法本研究以福建医科大学附属第二医院2021年9月—2023年6月病案首页诊断编码(疾病分类代码国临版2.0)为I60~I62的病例为研究对象,采用Kendall相关性分析进行单因素分析,将差异有统计学意义的变量纳入多元线性回归模型进行多因素分析。结果实行DRG支付费改革后,脑出血住院患者平均住院费用与自付金额分别下降26.17%和45.55%,控费效果较好;DRG支付方式下对住院费用影响最大的前4位因素是住院天数、是否手术、出院时已治愈以及住院时病重状态;DRG支付方式下,脑出血相关DRG分组呈盈利状态。结论DRG支付方式有效实现控费目标,改革成效明显;医疗机构应注意缩短住院天数,合理提高体现医疗价值的治疗费用占比,减少不必要的医药、耗材、检查等支出;医保部门应考虑将住院天数纳入DRG分组标准,综合考虑医疗服务质量、医保支付能力、患者个人经济负担,动态调整DRG分组支付标准。
