摘要:
目的 整合我国肝癌经济负担证据，为今后研究提供基线数据和方法参考。方法 系统检索PubMed、中国知网和万方数据库1996-2015年间发表文献，描述纳入研究基本特征并分析经济负担结果，费用贴现至2013年值，采用美国卫生保健质量和研究机构（agency for health care research and quality，AHRQ）推荐的量表开展质量评价。结果 最终纳入32篇文献。2篇基于人群的研究，报道的经济负担分别为37.8亿元（省级，直接和间接）和6.0亿元（市级，间接）。30篇基于个体的研究均报道了直接医疗费用，例均费用（21篇）年度中位数为11 663元（3 500~70 567元），次均费用（9篇）年度中位数为19 202元（7 005~41 118元），日均费用（13篇）年度中位数为865元（409~1 275元）；20年间三种指标费用均呈缓慢上升趋势；细化构成药品费居多（约56.6%）；5篇基于个体的研究报道了间接费用，中位数为73 440元（35 815~166 967元）。纳入研究质量一般。结论 肝癌在我国人群层面经济负担研究有限。不同地区的肝癌经济负担研究力度与其疾病负担不相匹配。例均费用数据报道较多，但结果解释应谨慎。此外，肝癌所致间接经济负担不容忽视。
关键词:
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肝肿瘤 /
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患病代价 /
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医疗费用 /
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综述
Abstract:
Objective To synthesize available evidence on the economic burden of liver cancer in China to inform future evaluations. Methods Articles were searched in PubMed, CNKI and wanfang literature database during 1996-2015. Description of basic characteristics, analyses of economic burden data and quality assessment were conducted, and all the expenditure data was discounted to the year 2013. Results A total of 32 studies were included for analysis. Only 2 population-level studies reported the economic burden of liver cancer, which was 3 780 million CHY (provincial, direct and indirect) and 600 million (municipal, indirect), respectively. There were 30 individual-level studies reporting direct medical expenditure of liver cancer, in which the median annual expenditure per patient from 21 studies was 11 663 CNY (3 500-70 567), the median annual expenditure per visit from 9 studies was 19 202 CNY (7 005-41 118) and the annual median expenditure per diem from 11 studies was 865 CNY (409-1 275). All the three expenditure indicators showed a slow increase in the past two decades, and drug accounted more than half of the overall expenditure (56.6%). From 5 individual-level studies, the median indirect expenditure was 73 440 CNY (35 815-166 967). The overall reporting quality was poor. Conclusions Current evidence on population-level economic burden of liver cancer is limited in China, and the focus of which is inconsistent with the severity of disease burden in various regions. Expenditure per patient was reported mostly, while results should be interpreted with caution. Lastly, the indirect economic burden of liver cancer should not be ignored in further studies.
百度学术
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