不同TNM分期乳腺癌患者的规范治疗成本分析  

Standard treatment cost of female breast cancer at different TNM stages

作　　者：李卉[1] 黄源[2] 黄蓉[2] 李佳圆[2] 

机构地区：[1]四川省肿瘤医院肿瘤研究所乳腺科,成都610041 [2]四川大学华西公共卫生学院

出　　处：《中华肿瘤杂志》2013年第12期946-950,共5页Chinese Journal of Oncology

基　　金：四川省卫生厅科学研究基金（080405）;成都市科技局科技支撑项目（11PPYB002SF-289）

摘　　要：目的分析不同TNM分期乳腺癌患者的规范治疗成本。方法采用既往资料摘录、临床路径、面访和电话访问等多种方法，对2009-2010年间四川省肿瘤医院乳腺外科收治的乳腺癌患者的治疗成本进行调查和分析。乳腺癌治疗成本包括直接医疗成本、直接非医疗成本和间接成本。结果共摘录316例乳腺癌患者的病历及住院费用信息，面访211组患者及家属，电话随访181例术后1年以上患者。根据患者的病情及意愿进行调整，得到规范治疗乳腺癌的平均总成本为160457元（约合$23702）。乳腺癌TNM分期为0期、I期、Ⅱ期、Ⅲ期和Ⅳ期患者的治疗总成本（包括术后放化疗后5年的门诊检查治疗费用）分别为37941、122622、159594、215014和214229元。早期乳腺癌的治疗成本远远低于中晚期乳腺癌。结论早期诊断、早期治疗乳腺癌有明确的经济学意义。Objective To evaluate the standard treatment cost of female breast cancer at different tumor node metastasis （TNM） stages. Methods Extracting previous data, calculating by clinical pathway, face-to-face interviewing, and telephone interviewing were adopted to estimate the treatment cost of female breast cancer. The cost was consisted of direct medical expenditure, direct non-medical expenditure, and indirect expenditure. Results The direct medical expenditure was extracted from medical record and expense statement of 316 breast cancer cases in Sichuan Cancer Hospital. The direct non-medical expenditure was investigated from 211 patients and their relatives. The indirect expenditure was surveyed from 181 cases who received surgery more than one year ago. The average treatment cost of female breast cancer was ￥ 160 457 （ $ 23 702）, which was adjusted by the proportions of ER, PR, and menses status, and the willingness of patients. The treatment cost （ including the outpatient cost for 5 years after surgery, radiotherapy, and chemotherapy） ofTNM 0 stage, TNM I stage, TNM II stage, TNM III stage, and TNM IV stage were ￥37 941, ￥122 622, ￥159 594, ￥215 014, and ￥214 229, respectively. The patients with early stage breast cancer payed considerably lower treatment cost than those at advanced stage. Conclusion Early detection and treatment of breast cancer may have a real economic significance for reducing the burden of disease.

关 键 词：乳腺肿瘤 肿瘤分期 成本及成本分析 

分 类 号：R737.9[医药卫生—肿瘤]