End-of-Life Costs in Cancer Patients: A Systematic Review.

Soraya Camargo Ito Süffert, Carlos Eduardo Aliatti Mantese, Felipe Rodrigo de Castro Meira, Katia Flavia Rosso de Oliveira Trindade, Ana Paula Beck da Silva Etges, Rafael José Vargas Alves, Claudia Giuliano Bica
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Abstract

Objectives: Identify the costs of an oncology patient at the end of life.

Methods: A systematic literature review was conducted by screening Embase, PubMed and Lilacs databases, including all studies evaluating end-of-life care costs for cancer patients up to March 2024. The review writing followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Drummond checklist. The protocol is available at PROSPERO CRD42023403186.

Results: A total of 733 studies were retrieved, and 43 were considered eligible. Among the studies analyzed, 41,86% included all types of neoplasms, 18.60% of lung neoplasm, All articles performed direct cost analysis, and 9.30% also performed indirect cost analysis. No study evaluated intangible costs, and most presented the macrocosting methodology from the payer's perspective. The articles included in this review presented significant heterogeneity related to populations, diagnoses, periods considered for evaluation of end-of-life care, and cost analyses. Most of the studies were from a payer perspective (74,41%) and based on macrocosting methodologies (81,39%), which limit the use of the information to evaluate variabilities in the consumption of resources.

Conclusions: Considering the complexity of end-of-life care and the need for consistent data on costs in this period, new studies, mainly in low- and middle-income countries with approaches to indirect and intangible costs, with a societal perspective, are important for public policies of health in accordance with the trend of transforming value-based care, allowing the health care system to create more value for patients and their families.

癌症患者的临终成本:系统回顾。
目标确定肿瘤患者临终关怀的成本:通过对Embase、PubMed和Lilacs数据库进行筛选,对截至2024年3月所有评估癌症患者临终关怀成本的研究进行系统性文献综述。综述的撰写遵循了《系统综述和元分析首选报告项目》指南。纳入研究的质量采用 Drummond 检查表进行评估。研究方案见 PROSPERO CRD42023403186.结果:结果:共检索到 733 项研究,其中 43 项符合条件。所有文章都进行了直接成本分析,9.30%的文章还进行了间接成本分析。没有研究对无形成本进行评估,大多数研究从支付方的角度介绍了宏观成本计算方法。纳入本综述的文章在人群、诊断、评估临终关怀的时间段和成本分析方面存在显著的异质性。大多数研究都是从支付方的角度出发(74.41%),并基于宏观成本计算方法(81.39%),这限制了信息在评估资源消耗差异方面的应用:考虑到临终关怀的复杂性以及对这一时期成本数据一致性的需求,主要在中低收入国家进行的新研究,采用了间接成本和无形成本的方法,具有社会视角,这对公共卫生政策非常重要,符合以价值为基础的医疗变革趋势,使医疗系统为患者及其家属创造更多价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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