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The Effect of the Type of Payer on Health Care Resource Utilization and Costs in Oncology Patients: A Retrospective Review of Electronic Medical Records

机译：付款人类型对肿瘤患者医疗资源利用和费用的影响：电子病历的回顾性回顾

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摘要

BACKGROUND: Cancer is one of the diseases with the greatest burden, out of which close to 56% of incident cases and 62% of deaths were reported in developing countries. Cancer treatment includes the use of surgical methods, chemotherapy, and radiation therapy. There is significant economic burden on patients from developing countries to treat cancer and the majority of them do not have insurance coverage. There is considerable interest in understanding the resource utilization and costs among cancer patients and assessing disparities in patients with different payers.;OBJECTIVES: The objectives of this study were: 1) to analyze the health care resource utilization and costs of patients treated for breast, oral, and ovarian cancer in a tertiary hospital in India, and 2) to evaluate the effect of the type of payer on health care utilization and cost of patients treated for breast, oral, and ovarian cancer in a tertiary hospital in India.;METHODS: Health resource utilization and costs data was obtained from the electronic medical record database of a tertiary hospital in Mumbai, India. Descriptive analysis, t-tests and chi-square tests were performed in the analysis. Simple and multiple linear regression models were run to assess the association between age, length of stay, number of clinician visits, payer type, patient type, comorbidities, cancer stage, and gender with total treatment cost.;RESULTS: For private insurance patients, the mean length of stay was highest among patients with breast (6.4+1.8 days) and ovarian (10.5+3.9 days) cancer, and for patients below the poverty line, it was the highest (11.0+2.8) among oral cancer patients. For patients with private insurance the highest number of per patient clinician visits were among breast (16.3 visits) and oral cancer (36.5 visits) patients, while those with no insurance had the highest number of per patient clinician visits among ovarian cancer (34.2 visits) patients. Among patients with oral and ovarian cancer, patients with no insurance received the highest number of unit doses of drugs, while patients with private insurance received the highest number of unit doses of drugs among breast cancer patients. Mean hospital costs were the highest for private insurance patients among breast ($2381.03+1739.31), oral ($5132.61+6158.41), and ovarian ($2735.00+2454.62) cancer patients. Among all the three cancer types in the study, patients with an advanced cancer stage incurred higher mean total costs than patients with early stage cancer. Surgical oncologist charges were the highest for breast, oral, and ovarian cancer patients.;CONCLUSIONS: Significant differences in resource utilization and costs were found in breast, oral, and ovarian cancer patients. Patients with private insurance and those paying out-of-pocket incurred higher costs but they used more resources in the hospital.
机译：背景：癌症是负担最重的疾病之一，在发展中国家，其中据报道有近56％的事件和62％的死亡。癌症治疗包括手术方法，化学疗法和放射疗法的使用。发展中国家的患者在治疗癌症方面承受着巨大的经济负担，其中大多数人没有保险。人们对了解癌症患者之间的资源利用和成本以及评估不同付款人之间的差异非常感兴趣。目的：本研究的目的是：1）分析乳腺癌治疗患者的医疗资源利用和成本，印度三级医院的口腔和卵巢癌，以及2）评价付款人类型对印度三级医院的乳腺癌，口腔和卵巢癌患者的医疗保健利用和费用的影响。 ：卫生资源利用和费用数据来自印度孟买一家三级医院的电子病历数据库。在分析中进行了描述性分析，t检验和卡方检验。运行简单多元线性回归模型以评估年龄，住院时间，临床就诊次数，付款人类型，患者类型，合并症，癌症分期和性别与总治疗费用之间的关联。结果：对于私人保险患者，乳腺癌（6.4 + 1.8天）和卵巢癌（10.5 + 3.9天）患者的平均住院时间最高，而贫困线以下的患者在口腔癌患者中的平均住院时间最高（11.0 + 2.8）。对于有私人保险的患者，乳腺癌（16.3次）和口腔癌（36.5次）患者中，每位患者的临床医生访问次数最高；而在卵巢癌（34.2次访问）中，无保险的患者中，每患者中的临床医生访问次数最多。耐心。在患有口腔癌和卵巢癌的患者中，没有保险的患者接受的单位剂量药物数量最高，而拥有私人保险的患者接受的乳腺癌单位剂量药物数量最高。在乳腺癌（2381.03 + 1739.31），口腔（5132.61 + 6158.41）和卵巢癌（2735.00 + 2454.62）癌症患者中，私人保险患者的平均住院费用最高。在研究的所有三种癌症类型中，癌症晚期患者的平均总费用要高于早期癌症患者。乳腺癌，口腔癌和卵巢癌患者的手术肿瘤费用最高。结论：乳腺癌，口腔癌和卵巢癌患者的资源利用和成本差异显着。有私人保险的患者和自付费用的患者会产生较高的费用，但他们在医院中使用了更多的资源。

著录项

  • 作者

    Abraham, Pranav Samuel.;

  • 作者单位

    Massachusetts College of Pharmacy and Health Sciences.;

  • 授予单位 Massachusetts College of Pharmacy and Health Sciences.;
  • 学科 Oncology.;Public health.;Economics.
  • 学位 Ph.D.
  • 年度 2017
  • 页码 416 p.
  • 总页数 416
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 生物数学方法;
  • 关键词

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