集中治療,生存,重症がん患者の治療費用
D V Schapira1, J Studnicki, D D Bradham
1Section of Cancer Prevention, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612.
JAMA
|February 10, 1993
まとめ
集中治療室 (ICU) に入院した重症がん患者は,生存期間と自宅での滞在時間が限られている. この研究は,これらの患者で得られた寿命の1年あたりの高いコストを定量化しています.
科学分野:
- 腫瘍学 腫瘍学
- クリティカルケア・メディシン
- 健康経済学 医療経済学
背景:
- ICUに入院している固体腫瘍や血液がんの患者は,しばしば予後が悪い.
- 生存率と費用対効果を理解することは,リソースの配分と患者のケアに関する決定に不可欠です.
研究 の 目的:
- 癌のICU患者の生存率と生存に影響を与える要因を決定する.
- 死亡前に自宅で過ごした時間を評価する (有意義な生存).
- 獲得した寿命の1年あたりのコストと,自宅で獲得した寿命の1年あたりのコストを計算します.
主な方法:
- 生存率と費用対効果の分析が行われました.
- データは,固体腫瘍を患った83人の患者と,血液がんを患った64人の患者から収集され,1988年から1990年の間に第三次ケアがんセンターのICUに入院した.
- 分析された要因には,年齢,性別,悪性腫瘍の種類,ICUでの滞在期間,および機械呼吸器の必要性が含まれています.
主要な成果:
- 機械呼吸は,血液がん患者の生存に影響を与える唯一の重要な要因でした.
- 患者の75%以上が死亡前に自宅で3ヶ月未満を過ごしました.
- 獲得した寿命の1年あたりのコストは,固体腫瘍の場合は82,845ドル,血液がんの場合は189,339ドルであった.
結論:
- 集中治療室に入院するほとんどのがん患者は,生存期間が限られ,自宅での時間は最小限であり,かなりの経済的コストがかかります.
- 医師は,適切なケア戦略を確立するために,患者および家族と予後および生命維持装置の撤回の可能性について議論する必要があります.
- これは,重症がん患者の積極的な治療法を慎重に検討する必要性を強調しています.
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