頭頸部がんにおける患者による症状と直接的な医療費
Kennedy Ayoo1,2,3,4,5, Rinku Sutradhar1,3,4, Qing Li3,4
1Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
JAMA otolaryngology-- head & neck surgery
|September 4, 2025
まとめ
エドマントン症状評価システム (ESAS) の患者報告結果は,頭頸部がん (HNC) の患者の医療費と関連しています. 症状のスコアが高くなるのは30日間の医療費の増加を示し,PROMはコスト削減戦略を促す可能性があることを示唆しています.
科学分野:
- 腫瘍学
- 健康 経済
- 患者による報告結果
背景:
- 頭頸部がん (HNC) は 重要な機能的,心理的,経済的負担を伴う.
- HNCの完全な影響を評価するには,患者による結果測定 (PROM) が不可欠です.
- PROMとHNCの医療費の関係については,明確にする必要があります.
研究 の 目的:
- エドマントン症状評価システム (ESAS) のスコアと,成人HNC患者の30日間の直接的な医療費との関連性を評価する.
主な方法:
- カナダのオンタリオ州 (2007年−2023年) の関連行政データを用いてコホート研究が行われた.
- コプライマリー被曝は,最も高い個々の症状スコア (h-ESAS) と総症状スコア (t-ESAS) を含む.
- 多変数負の二項回帰モデルは,ESASスコアと30日間のコストとの関連を評価し,共変数を制御した.
主要な成果:
- h-ESASの1ポイントの上昇は,30日間のコストの22%の上昇と相関していた (RR,1.22).
- より高いt-ESASスコアは,相対的なコストの漸進的な増加を示し,ピークは71-80であった (RR,4.82).
- 16,544人のHNC患者と90, 025人のESAS評価を分析した.
結論:
- h-ESASとt-ESASの両方のスコアは,HNC患者の30日間の医療費と有意に関連しています.
- ESASのようなPROMは,HNCケアのためのコスト削減戦略の開発に役割を果たす可能性があります.
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