中国循证医学杂志

中国循证医学杂志

中国肺癌患者直接医疗费用研究的系统评价

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目的系统评价中国肺癌患者的直接医疗费用研究。方法计算机检索 PubMed、Scopus、The Cochrane Library、CNKI、WanFang Data 和 VIP 数据库,搜索与中国肺癌患者医疗费用有关的研究,检索时限均为建库至 2017 年 9 月。采用 Molinier 等的评价工具对纳入研究的偏倚风险进行了评价,重点分析了直接医疗费用、住院费用、门诊费用的总量和结构,并探讨了不同治疗方案和疾病病程对肺癌患者直接医疗费用的影响。结果共纳入 42 篇文献。中国肺癌患者年人均直接医疗费用为 55 295~77 431 元,次均门诊费用为 528~2 620 元,次均住院费用为 8 582~65 562 元,药费在次均住院费中的占比最大(35.9%~68.4%)。肺癌患者采用不同治疗方案的直接医疗费用不同,手术患者费用多高于非手术患者,不同化疗方案的费用差异明显。结论中国肺癌患者直接医疗费用负担较重,需要进一步加强对肺癌全周期治疗费用和靶向药物治疗费用的卫生经济学研究,进一步规范费用指标的表述和分析方法。

ObjectivesTo systematically review the direct medical cost and burden of lung cancer in Chinese population.MethodsDatabases such as PubMed, Scopus, CNKI, VIP and WanFang Data were searched for studies investigating cost or burden of lung cancer in Chinese population from inception to September, 2017. Based on inclusion and exclusion criteria, two researchers screened literature, extracted data, and assessed methodological quality of included studies according to methods from Molinier, LA. Descriptive analysis was used to analyze the direct medical cost in conjunction with its composition and other aspects including various costs of different therapeutic regimens and temporal trends.ResultsA total of 42 studies were included. The direct medical cost per person per year varied from 55 295 yuan to 77 431 yuan. In addition, the direct medical cost for hospitalization ranged from 8 582 yuan to 65 562 yuan. The cost of drug accounted for the largest part. Costs showed differences in diverse treatment regimens and time periods.ConclusionsHigh quality studies on direct medical cost of lung cancer in China are rare. The direct medical burden of lung cancer in China is seriously high. As a consequence, control work is urgently required. Numerous factors including sample size, region, methods for dealing with data and value sets could influence the measurement results of cost. Future research could set focus on analysis based on time dimension, cost of target drug as well as the adverse effects caused by medication.

关键词: 肺癌; 直接医疗费用; 中国; 系统评价

Key words: Lung cancer; Direct medical cost; China; Systematic review

引用本文: 宋佳芳, 官海静, 刘国恩. 中国肺癌患者直接医疗费用研究的系统评价. 中国循证医学杂志, 2019, 19(1): 44-53. doi: 10.7507/1672-2531.201808083 复制

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