在癌症老年人中,放射治疗发作的实践水平支出变化
Miranda B Lam1, Mary Beth Landrum2, J Michael McWilliams2,3
1Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, Massachusetts.
JAMA health forum
|July 18, 2025
概括
针对癌症护理的辐射支出在各个实践中存在很大差异,即使在调整了患者和治疗因素之后. 这突出了通过替代支付模式的潜在成本节约.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 放射治疗是癌症治疗的关键但又昂贵的一个方面.
- 了解支出趋势和实践变化对于优化医疗保健成本至关重要.
- 识别影响成本变化的因素可以为支付模式设计提供信息.
研究的目的:
- 分析2009年至2020年放射治疗支出趋势.
- 确定导致实践水平辐射开支变化的因素.
- 为癌症护理提供替代支付模式的设计提供信息.
主要方法:
- 一个以人口为基础的,对收费服务医疗保险受益人的跨部门研究 (2009-2020年).
- 对标准化90天辐射治疗费用的分析,检查辐射类型和分数的变化.
- 用实践随机效应的线性回归模型来评估支出变化.
主要成果:
- 平均90天标准化支出为13,683美元,实践水平差异很大 (年调整后4,121美元,进一步调整后1,487美元).
- 从2009年到2020年,支出略有增加,而分数数量减少,先进技术 (强度调制,质子) 的使用增加.
- 尽管调整了许多患者和治疗特征,但支出仍然存在实践层面的显著差异.
结论:
- 在老年癌症患者的实践水平辐射支出和治疗强度方面存在很大差异.
- 这些变化发生在医疗保健市场内和医疗保健市场之间.
- 在基于人口的支付模式中,可能存在节省成本的机会.
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