美国老年女性乳腺癌查的使用,成本和价值的变化
Ilana Richman1,2, Jessica B Long3,4, Meghan E Lindsay3,4
1Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA. ilana.richman@yale.edu.
Journal of general internal medicine
|September 23, 2025
概括
老年妇女的乳腺癌查费用大幅增加,主要是由于对潜在的成本效益较低的技术的支出. 将重点从低价值查转向高价值查可以改善结果并节省资金.
科学领域:
- 老年医学 老年医学
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 乳腺癌查的临床和经济影响因模式,频率和患者年龄而异.
- 老年女性是乳腺癌查计划的重要人口.
研究的目的:
- 分析老年妇女乳腺癌查的使用趋势和相关成本.
- 在这个人群中区分成本有效和成本无效的查策略.
主要方法:
- 一个连续的横截面研究,利用2009年至2019年的SEER-Medicare数据.
- 分析的重点是67岁及以上的医疗保险服务费受益者.
- 查被分类为具有成本效益 (例如,两年一次的乳腺扫描<80) 或成本效益低下 (例如,每年一次的乳腺扫描,数字乳腺瘤合成,查超声波,任何查≥80).
主要成果:
- 在65-79岁的女性中,两年一次的查使用率保持稳定,而年度查略有下降.
- 80岁及以上女性的查使用率从19%下降到12.9%.
- 对成本无效查的支出增加了87% (从5.48亿美元增加到1025亿美元),占到2019年总支出的58%.
结论:
- 老年妇女的乳腺癌查费用有所增加,主要是由于潜在的非成本效益技术.
- 将资源从低价值重新分配到高价值的选和后续测试可以产生显著的节省.
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