在低收入和中等收入国家定义和衡量金融毒性
Stephanie G Raptis1, Brian Shkabari1, Saquib Banday2
1Division of Cancer Care and Epidemiology, Queen's University, Kingston, ON, Canada.
JCO oncology practice
|January 10, 2025
概括
癌症患者的金融毒性 (FT) 是低收入和中等收入国家 (LMICs) 的一个重要问题. 专注于应对机制的定义更好地反映了FT的真正负担,而不是基于支出的措施.
科学领域:
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
- 全球健康 全球健康
背景情况:
- 金融毒性 (FT) 是全球癌症患者日益关注的问题.
- 现有的FT研究主要来自高收入国家,这限制了对LMICs的适用性.
- 在LMICs中,FT的具体原因,后果和定义仍未得到充分研究.
研究的目的:
- 审查和综合用于LMIC癌症患者研究中的FT的各种定义.
- 在LMIC设置中记录FT的大小,根据LMIC设置中的不同定义报告.
- 确定在LMICs中定义和测量FT的潜在改进.
主要方法:
- 按照PRISMA指南在MEDLINE,科学网络和CINAHL进行系统的文献搜索.
- 包括在2023年之前发表的LMIC癌症患者的FT研究.
- 对FT定义的分类和报告的FT大小的分析.
主要成果:
- 68项研究符合纳入标准,自2020年以来出版物激增.
- 确定了FT的不同定义,包括灾难性医疗支出 (45%),家庭贫困 (10%) 和金融毒性综合评分工具 (26%).
- 在所有定义中都观察到大量的FT,并且经常引用应对机制和主观的财务负担.
结论:
- 目前在LMICs中对FT的定义有很大的差异.
- 与基于支出的指标相比,包含应对机制或困难的定义可能更准确地反映了FT的规模.
- 未来的研究应该专注于为LMIC环境制定与当地相关的FT定义.
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