PDF(Pubmed)
Abstract：
India accounts for almost a third of the global burden of oral cancer, a situation worsened by the inability to afford care. When available, aid is often insufficient, and costing is based on informal estimations. This study objectively determines direct healthcare costs of oral cancer in India. The study was performed from a healthcare provider\'s perspective using a validated bottom-up method. Care pathways were determined by prospectively observing the natural management of 100 oral cancer patients treated between October 2019 and March 2020. Specific costing categories were built across services, and apportioned values for each interaction was averaged. Costs of treatment and service utilisation were obtained using probabilistic sensitivity analyses. The unit cost of treating advanced stages (United States Dollar (USD) 2,717) was found to be 42% greater than early stages (USD1,568). There was an 11% reduction in unit costs with increases in socioeconomic status. Medical equipment accounted for 97.8% of capital costs, with the highest contributor being imaging services. Variable costs for surgery in advanced stages were 1.4 times higher than early stages. Compared to surgery alone, the average cost of treatment increased by 44.6% with adjuvant therapy. These results show that over the next decade, India will incur an economic burden of USD 3 billion towards the direct healthcare of oral cancer. Early detection and prevention strategies leading to 20% reduction in advanced stage disease could save USD 30 million annually. These results are critical to deliver a disease-driven and objective reform for oral cancer care.
摘要：
印度占全球口腔癌负担的近三分之一，无力负担医疗费用使情况恶化。如果可用,援助往往不够,成本计算是基于非正式的估计。这项研究客观地确定了印度口腔癌的直接医疗成本。该研究是从医疗保健提供者的角度使用经过验证的自下而上方法进行的。护理途径是通过前瞻性观察2019年10月至2020年3月期间接受治疗的100名口腔癌患者的自然管理来确定的。特定的成本计算类别是跨服务构建的，并对每个相互作用的分配值进行平均。使用概率敏感性分析获得治疗和服务利用的成本。发现治疗晚期的单位成本(美元(2,717美元))比早期阶段(1,568美元)高42%。随着社会经济地位的提高，单位成本降低了11%。医疗设备占资本成本的97.8%，最大的贡献者是影像服务。晚期手术的可变费用是早期手术的1.4倍。与单纯手术相比,辅助治疗的平均治疗费用增加了44.6%.这些结果表明，在接下来的十年中，印度将在口腔癌的直接医疗保健方面承担30亿美元的经济负担。早期发现和预防策略可将晚期疾病减少20％，每年可节省3000万美元。这些结果对于为口腔癌护理提供疾病驱动和客观的改革至关重要。
