抗雄激素转移

Simon P. Kim, E. Moran, E. Bowes, Adam G. Tennant, C. Bennett
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引用次数: 4

摘要

目的:经济和非经济障碍影响前列腺癌患者的护理。在本研究中,我们评估了经济考虑是否是低收入前列腺癌退伍军人将其护理转移到退伍军人事务部(VA)医院的主要原因,如果是的话,医疗护理的哪些方面受这些考虑的影响最大。材料和方法:对106名前列腺癌退伍军人进行访谈,这些退伍军人的护理转移到VA医疗系统。受访者提供了关于他们转移护理的主要原因的信息。结果:尽管64.2%的患者在首次就诊前有私人医疗保险,但只有26.4%的患者在访谈时保留了私人医疗保险,53.8%的患者在诊断为前列腺癌后将其全部医疗服务转移到退伍军人事务部。将护理转移到退伍军人管理局的原因包括口服抗雄激素治疗的费用(34.9%),医生就诊的共同支付费用(30.2%),感觉退伍军人管理局系统的医疗服务会更好(26.4%),以及黄体生成素释放激素类似物的共同支付费用(8.5%)。转移的原因随诊断时疾病分期不同而不同(p < 0.05)。转移的最常见原因是转移性患者的抗雄激素治疗费用,以及局部癌症患者的医生共付费用,以及认为VA系统的护理质量更高。结论:我们的研究结果表明存在一种被称为“抗雄激素转移”的现象,这种现象导致患有转移性前列腺癌的退伍军人转移到退伍军人事务部。医疗保险计划的综合药品福利的制定将影响转移性前列腺癌患者向退伍军人医疗系统的转移。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Anti‐Androgen Transfer
Objectives: Financial and nonfinancial barriers affect the care of prostate cancer patients. In this study, we evaluated whether financial considerations were a primary reason for lower income veterans with prostate cancer to transfer their care to Veterans Affairs (VA) Hospitals, and if so, which aspects of medical care were most affected by these considerations. Materials and Methods: Interviews with 106 veterans with prostate cancer were undertaken after the transfer of their care to the VA medical system. Respondents provided information about the primary reasons they shifted their care. Results: Although 64.2% of the patients had private health insurance before their initial visit to the VA, only 26.4% retained their private health insurance at the time of the interview, and 53.8 % transferred their entire medical care to the VA after the diagnosis of prostate cancer. Reasons for transferring care to the VA included the costs of oral anti-androgen therapy (34.9%), copayment costs for physician visits (30.2%), a feeling that medical care would be better in the VA system (26.4%), and copayment costs of luteinizing hormone-releasing hormone analogs (8.5%). Reasons for transfer varied with stage of disease at diagnosis (p < 0.05). The most common reasons for transfer were anti-androgen therapy costs among metastatic patients and, among patients with localized cancer, physician copayments and a feeling that care would be of higher quality in the VA system. Conclusions: Our findings suggest that there is a phenomenon, termed the “anti-androgen transfer,” that leads veterans with metastatic prostate cancer to transfer to the VA setting. The enactment of a comprehensive pharmaceutical benefit to the Medicare program will affect transfers of metastatic prostate cancer patients to the VA medical system.
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