美国癌症幸存者癌症治疗后疼痛的直接经济负担:一项基于人群的回顾性纵向研究。

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Yves Paul Vincent Mbous, Rowida Mohamed, Uche Osahor, Traci J LeMasters
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引用次数: 0

摘要

目的:癌症治疗后疼痛(PCTP)在癌症幸存者中普遍存在,但仍未得到充分研究。随着时间的推移,量化PCTP的患病率,并估计由此产生的短期和长期的增量医疗保健支出(总数、第三方和自付费用)以及癌症幸存者的自付负担,这一点至关重要。方法:采用纵向回顾性队列设计。采用医疗支出小组调查(MEPS)及其补充的癌症自我管理问卷(CSAQ)来确定患有PCTP的癌症幸存者(≥18岁)。利用对数链接和伽马分布的广义线性模型(GLM)的循环预测来估计不同PCTP等级的年度医疗保健支出增量。为了解释协变量不平衡,使用逆概率加权进行敏感性分析。结果:2125例癌症幸存者有PCTP。癌症治疗后,10.5%-24.2%的幸存者经历了某种形式的慢性PCTP,而21.9%-5.1%的幸存者经历了急性PCTP。在整个生存过程中,与无疼痛的癌症幸存者相比,中度慢性PCTP(癌症治疗后< 1年)和重度慢性PCTP(癌症治疗后≥5年)的癌症幸存者调整后的年度总增量医疗保健支出最高,全国分别达到273亿美元和402亿美元。与没有疼痛的癌症幸存者相比,患有严重慢性PCTP的癌症幸存者的自费负担明显较高。结论:这些发现强调了PCTP持续的经济负担,但也迫切需要有效的疼痛管理,以及使用患者报告的癌症幸存者疼痛结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Direct Economic Burden of Post-Cancer Treatment Pain Among Cancer Survivors in the United States: A Population-Based Retrospective Longitudinal Study.

Purpose: Post-cancer treatment pain (PCTP) is prevalent among cancer survivors but remains understudied. It is critical to quantify PCTP prevalence over time and to estimate the resulting short and long-term incremental healthcare expenditures (total, third-party, and out-of-pocket) and out-of-pocket burden among cancer survivors.

Methods: A longitudinal retrospective cohort design was used. To identify cancer survivors (≥ 18 years) with PCTP, the Medical Expenditure Panel Survey (MEPS) and its supplementary Cancer Self-Administered Questionnaire (CSAQ)were used. Recycled predictions from generalised linear models (GLM) with log-link and gamma distribution were used to estimate annual incremental healthcare expenditures at different PCTP gradations over time. To account for covariate imbalance, sensitivity analysis using inverse probability weighting was conducted.

Results: 2125 cancer survivors had PCTP. Post-cancer treatment, 10.5%-24.2% of survivors experienced some form of chronic PCTP, whereas between 21.9%-5.1% experienced acute PCTP. Across the survivorship journey, the adjusted total annual incremental healthcare expenditures were the highest among cancer survivors with moderate chronic PCTP (< 1-year post-cancer treatment), and severe chronic PCTP, (≥ 5 years post-cancer treatment) compared to survivors with no pain, reaching respectively, $27.3 and $40.2 billion nationally. There was a significant high out-of-pocket burden among cancer survivors with severe chronic PCTP compared to those with no pain.

Conclusion: These findings highlight the persistent financial burden of PCTP but also the critical need for effective pain management alongside the use of patient-reported outcomes for pain among cancer survivors.

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来源期刊
CiteScore
4.50
自引率
3.70%
发文量
197
期刊介绍: Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.
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