مدیریت هزینه اثر بخشی روش‌های درمانی در کودکان مبتلا به سرطان: یک مطالعه مروری
محورهای موضوعی : -اقتصاد بهداشت و درمانزینب حاجی تبار 1 , سید جمال الدین طبیبی 2 , سید داوود نصرالله پور شیروانی 3 , بایرام پاکروان 4
1 - دانشجوی دکتری، گروه مدیریت بهداشتی درمانی، دانشکده پزشکی، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
2 - استاد، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده بهداشت، دانشگاه علوم پزشکی بابل، مازندران، ایران
4 - استادیار، علوم اقتصادی، واحد سمنان، دانشگاه آزاد اسلامی، سمنان، ایران
کلید واژه: هزینه, سرطان, هزینه - اثربخشی, ارزشیابی اقتصادی, هزینه - منفعت, کودکان,
چکیده مقاله :
مقدمه: ارزشیابی هزینه اثر بخشی مداخلات درمانی برای تخصیص بهینه منابع در بخش سلامت به خصوص در کشورهای کم برخوردار حائز اهمیت است. هدف این پژوهش مرور روایتی بررسی مقایسه‌ای روش‌های درمانی در کودکان مبتلا به سرطان است. روش پژوهش: مطالعه حاضر با جستجو در چهار پایگاه اطلاعاتی SID، Scopus، Pubmed و Google Scholar با استفاده از کلید واژه های( هزینه-اثربخشی، ارزشیابی اقتصادی، هزینه - منفعت، هزینه، سرطان، کودکان) برای یافتن مقالات مرتبط منتشر شده بین سال‌های 2000 تا 2020 میلادی انجام شد. مقالات بدست امده پس از انطباق با معیارهای ورود وارد مطالعه شدند. یافته‌ها: پس از بررسی معیارهای ورود 8 مطالعه وارد مطالعه مروری حاضر شد. در اکثر مطالعات روش‌های جراحی یا داروهای جدیدتر از نظر اقتصادی نیز مقرون به صرفه‌تر بودند (مانند لاپاراسکوپی یا داروهای نوترکیب). اکثر مطالعات ارزش اقتصادی روش‌های درمانی را بصورت تحلیل هزینه - منفعت مورد بررسی قرار داده بودند. نتیجه‌گیری: مطالعات اولیه تحلیل هزینه - منفعت در حوزه مداخلات بهداشتی و درمانی در حال افزایش است. زیرا این گونه تحلیل‌ها می‌تواند در بهینه‌سازی استفاده از منابع و امکانات و ارتقای سلامت مردم نقش مهمی ایفا نماید. مطالعات مروری می‌تواند با تجمیع نتایج مطالعات اولیه در جهت برنامه‌ریزی‌های صحیح مالی به مدیران و سیاست‌‌گذاران حوزه سلامت کمک شایانی نماید.
Cost-effectiveness evaluation of therapeutic interventions is important for optimal allocation of resources in the health sector, especially in developing countries. This research is a narrative review aiming at comparison of treatment methods in children with cancer. Methods: The present study was conducted by searching four databases, SID, Scopus, Pubmed and Google Scholar using keywords (cost-effectiveness, economic evaluation, cost-benefit, cost, cancer, and children) to find related articles published between 2000 and 2020. The obtained articles were included in the study after complying with the inclusion criteria. Results: After checking the inclusion criteria, 8 studies were included in the present review. In most studies, surgical procedures or newer drugs (such as laparoscopy or recombinant drugs) were more cost-effective. Most of the studies had examined the economic value of treatment methods in the form of cost-benefit analysis. Conclusion: Primary studies of cost-benefit analysis in the field of health interventions are increasing. Because such analyzes can play an important role in optimizing the use of resources and facilities and improving health status of communities. Review studies can help health managers and policymakers by summarizing the results of primary studies for proper financial planning.
1- Ahsanipoor H. Tsunami in Cancer.[On Line]; 2009.
2-Almasihashiani A ZS, Hosseini H, Dehghan A.. Factors determining recurrence of leukemia in children in
fars province. Journal of Arak University of Medical Sciences, 2012; 6(1): 7-1.
3-Wiener L, Kazak AE, Noll RB, Patenaude AF, Kupst MJ. Standards for the psychosocial care of children with cancer and their families: an introduction to the special issue. Pediatric blood & cancer, 2015; 62(S5): S419-S24.
4- Magrath I, Steliarova-Foucher E, Epelman S, Ribeiro RC, Harif M, Li C-K, et al. Paediatric cancer in low-income and middle-income countries. The lancet oncology, 2013; 14(3): e104-e16.
5- Loeffen EA, Knops RR, Boerhof J, Feijen EL, Merks JH, Reedijk AM, et al. Treatment-related mortality in children with cancer: Prevalence and risk factors. European Journal of Cancer, 2019; 121: 113-22.
6- Price RA, Stranges E, Elixhauser A. Pediatric cancer hospitalizations, 2009: statistical brief# 132; 2012.
7- Force LM, Abdollahpour I, Advani SM, Agius D, Ahmadian E, Alahdab F, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. The Lancet Oncology, 2019; 20(9): 1211-25.
8- Zikos D, Mitsios A, Mantas J. Assessment of hospital information systems implementation: a case study. e-Health Across Borders Without Boundaries: IOS Press; 2011: 123-8.
9- Rahimi B, Vimarlund V. Methods to evaluate health information systems in healthcare settings: a literature review. Journal of medical systems, 2007; 31(5): 32- 97.
10- Aghaee Talikani Z, Riahi L, Nasiripour AA. The Effect of Accreditation Interventions on Patient Safety Measurement in Operating Rooms of one of Tehran Social Security Hospitals. Journal of healthcare management, 2022; 13(1): 71-83.
11- Roser K, Erdmann F, Michel G, Winther JF, Mader L. The impact of childhood cancer on parents' socio‐economic situation—a systematic review. Psycho‐Oncology, 2019; 28(6): 1207-26.
12- Russell HV, Panchal J, VonVille H, Franzini L, Swint JM. Economic evaluation of pediatric cancer treatment: a systematic literature review. Pediatrics, 2013; 131(1): e273-e87.
13- Goeree R, He J, O’Reilly D, Tarride J-E, Xie F, Lim M, et al. Transferability of health technology assessments and economic evaluations: a systematic review of approaches for assessment and application. ClinicoEconomics and outcomes research: CEOR, 2011; 3: 89.
14- Kirchhoff AC, Krull KR, Ness KK, Armstrong GT, Park ER, Stovall M, et al. Physical, mental, and neurocognitive status and employment outcomes in the childhood cancer survivor study cohort. Cancer Epidemiology, Biomarkers & Prevention, 2011; 20(9): 1838-49.
15- Koch T. Story telling: is it really research? Journal of advanced nursing, 1998; 28(6): 1182-90.
16- Uman LS. Systematic reviews and meta-analyses. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2011; 20(1): 57.
17- Weinstein MC, Torrance G, McGuire A. QALYs: the basics. Value in health; 2009.
18- Mosadeghrad AM. . Principles of health. care management,. Tehran, Iran: Dibagran Tehran; 2003.
19- Longo C, Deber R, Fitch M, Williams A, D’souza D. An examination of cancer patients’ monthly ‘out‐of‐pocket’costs in Ontario, Canada. European journal of cancer care, 2007; 16(6): 500-7.
20- Park J, Look KA. Health care expenditure burden of cancer care in the United States. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2019; 56: 0046958019880696.
21- Langa KM, Fendrick AM, Chernew ME, Kabeto MU, Paisley KL, Hayman JA. Out‐of‐pocket health‐care expenditures among older Americans with cancer. Value in Health, 2004; 7(2): 186-94.
22- Bazyar M, Pourreza A, Harirchi I, Akbari F, Mahmoudi M. Medical and non-medical direct costs of cancers in patients hospitalized in Imam Khomeini cancer institution-2010. Hospital, 2012; 11: 39-150.
23- Moafi A, Soheilipoor F, Amini A, Beheshti M. Comparing efficacy and side effects of Pd-Grastim and Neupogen for prevention of neutropenia after chemotherapy in children; 2006.
24- Stanford A, Upperman JS, Nguyen N, Barksdale Jr E, Wiener ES. Surgical management of open versus laparoscopic adrenalectomy: outcome analysis. Journal of pediatric surgery, 2002; 37(7): 1027-9.
25- Davari M, Moafi A, Yarmohammadian MH, Haghighi EK. The direct medical costs of acute lymphocytic leukemia (ALL) in children in Isfahan province. Health Information Management, 2015; 11(7): 1047-57.
26- Baghban A, Esmaeely M, Kimafar K. Management of medical information and estimation of direct cost of cancer treatment of the lung. Health Inf Manage, 2009; 5: 151-8.
27- Madero L, Vicent MG, Ramirez M, Quintero V, Benito A, Diaz M. Clinical and economic comparison of allogeneic peripheral blood progenitor cell and bone marrow transplantation for acute lymphoblastic leukemia in children. Bone marrow transplantation, 2000; 26(3): 269.
28- Lin Y-F, Lairson DR, Chan W, Du XL, Leung KS, Kennedy-Nasser AA, et al. The costs and cost-effectiveness of allogeneic peripheral blood stem cell transplantation versus bone marrow transplantation in pediatric patients with acute leukemia. Biology of Blood and Marrow Transplantation, 2010; 16(9): 81-1272.
29- Hall W, Kowalik K, Liu H, Truwit C, Kucharczyk J. Costs and benefits of intraoperative MR-guided brain tumor resection. Intraoperative Imaging in Neurosurgery: Springer; 2003: 42-137.
30- Saxton AT, Bhattacharya M, Masalu N, Rice HE, Schroeder K. Cost-effectiveness of pediatric cancer treatment in Tanzania: An economic analysis. American Society of Clinical Oncology; 2017.
31- Stolarska M MW, Zalewska-Szewczyk B, Bodalski J. Cytoprotective effect of amifostine in the treatment of childhood neoplastic diseases-a clinical study including the pharmacoeconomic analysis. Pharmacological reports, 2006; 58(1): 30.
Annemans L, Moeremans K, Lamotte M, Garcia Conde J, Van Den Berg H, Myint H, et al. Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients. Supportive care in cancer, 2003; 11(4): 57-249.
_||_1- Ahsanipoor H. Tsunami in Cancer.[On Line]; 2009.
2-Almasihashiani A ZS, Hosseini H, Dehghan A.. Factors determining recurrence of leukemia in children in
fars province. Journal of Arak University of Medical Sciences, 2012; 6(1): 7-1.
3-Wiener L, Kazak AE, Noll RB, Patenaude AF, Kupst MJ. Standards for the psychosocial care of children with cancer and their families: an introduction to the special issue. Pediatric blood & cancer, 2015; 62(S5): S419-S24.
4- Magrath I, Steliarova-Foucher E, Epelman S, Ribeiro RC, Harif M, Li C-K, et al. Paediatric cancer in low-income and middle-income countries. The lancet oncology, 2013; 14(3): e104-e16.
5- Loeffen EA, Knops RR, Boerhof J, Feijen EL, Merks JH, Reedijk AM, et al. Treatment-related mortality in children with cancer: Prevalence and risk factors. European Journal of Cancer, 2019; 121: 113-22.
6- Price RA, Stranges E, Elixhauser A. Pediatric cancer hospitalizations, 2009: statistical brief# 132; 2012.
7- Force LM, Abdollahpour I, Advani SM, Agius D, Ahmadian E, Alahdab F, et al. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. The Lancet Oncology, 2019; 20(9): 1211-25.
8- Zikos D, Mitsios A, Mantas J. Assessment of hospital information systems implementation: a case study. e-Health Across Borders Without Boundaries: IOS Press; 2011: 123-8.
9- Rahimi B, Vimarlund V. Methods to evaluate health information systems in healthcare settings: a literature review. Journal of medical systems, 2007; 31(5): 32- 97.
10- Aghaee Talikani Z, Riahi L, Nasiripour AA. The Effect of Accreditation Interventions on Patient Safety Measurement in Operating Rooms of one of Tehran Social Security Hospitals. Journal of healthcare management, 2022; 13(1): 71-83.
11- Roser K, Erdmann F, Michel G, Winther JF, Mader L. The impact of childhood cancer on parents' socio‐economic situation—a systematic review. Psycho‐Oncology, 2019; 28(6): 1207-26.
12- Russell HV, Panchal J, VonVille H, Franzini L, Swint JM. Economic evaluation of pediatric cancer treatment: a systematic literature review. Pediatrics, 2013; 131(1): e273-e87.
13- Goeree R, He J, O’Reilly D, Tarride J-E, Xie F, Lim M, et al. Transferability of health technology assessments and economic evaluations: a systematic review of approaches for assessment and application. ClinicoEconomics and outcomes research: CEOR, 2011; 3: 89.
14- Kirchhoff AC, Krull KR, Ness KK, Armstrong GT, Park ER, Stovall M, et al. Physical, mental, and neurocognitive status and employment outcomes in the childhood cancer survivor study cohort. Cancer Epidemiology, Biomarkers & Prevention, 2011; 20(9): 1838-49.
15- Koch T. Story telling: is it really research? Journal of advanced nursing, 1998; 28(6): 1182-90.
16- Uman LS. Systematic reviews and meta-analyses. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2011; 20(1): 57.
17- Weinstein MC, Torrance G, McGuire A. QALYs: the basics. Value in health; 2009.
18- Mosadeghrad AM. . Principles of health. care management,. Tehran, Iran: Dibagran Tehran; 2003.
19- Longo C, Deber R, Fitch M, Williams A, D’souza D. An examination of cancer patients’ monthly ‘out‐of‐pocket’costs in Ontario, Canada. European journal of cancer care, 2007; 16(6): 500-7.
20- Park J, Look KA. Health care expenditure burden of cancer care in the United States. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2019; 56: 0046958019880696.
21- Langa KM, Fendrick AM, Chernew ME, Kabeto MU, Paisley KL, Hayman JA. Out‐of‐pocket health‐care expenditures among older Americans with cancer. Value in Health, 2004; 7(2): 186-94.
22- Bazyar M, Pourreza A, Harirchi I, Akbari F, Mahmoudi M. Medical and non-medical direct costs of cancers in patients hospitalized in Imam Khomeini cancer institution-2010. Hospital, 2012; 11: 39-150.
23- Moafi A, Soheilipoor F, Amini A, Beheshti M. Comparing efficacy and side effects of Pd-Grastim and Neupogen for prevention of neutropenia after chemotherapy in children; 2006.
24- Stanford A, Upperman JS, Nguyen N, Barksdale Jr E, Wiener ES. Surgical management of open versus laparoscopic adrenalectomy: outcome analysis. Journal of pediatric surgery, 2002; 37(7): 1027-9.
25- Davari M, Moafi A, Yarmohammadian MH, Haghighi EK. The direct medical costs of acute lymphocytic leukemia (ALL) in children in Isfahan province. Health Information Management, 2015; 11(7): 1047-57.
26- Baghban A, Esmaeely M, Kimafar K. Management of medical information and estimation of direct cost of cancer treatment of the lung. Health Inf Manage, 2009; 5: 151-8.
27- Madero L, Vicent MG, Ramirez M, Quintero V, Benito A, Diaz M. Clinical and economic comparison of allogeneic peripheral blood progenitor cell and bone marrow transplantation for acute lymphoblastic leukemia in children. Bone marrow transplantation, 2000; 26(3): 269.
28- Lin Y-F, Lairson DR, Chan W, Du XL, Leung KS, Kennedy-Nasser AA, et al. The costs and cost-effectiveness of allogeneic peripheral blood stem cell transplantation versus bone marrow transplantation in pediatric patients with acute leukemia. Biology of Blood and Marrow Transplantation, 2010; 16(9): 81-1272.
29- Hall W, Kowalik K, Liu H, Truwit C, Kucharczyk J. Costs and benefits of intraoperative MR-guided brain tumor resection. Intraoperative Imaging in Neurosurgery: Springer; 2003: 42-137.
30- Saxton AT, Bhattacharya M, Masalu N, Rice HE, Schroeder K. Cost-effectiveness of pediatric cancer treatment in Tanzania: An economic analysis. American Society of Clinical Oncology; 2017.
31- Stolarska M MW, Zalewska-Szewczyk B, Bodalski J. Cytoprotective effect of amifostine in the treatment of childhood neoplastic diseases-a clinical study including the pharmacoeconomic analysis. Pharmacological reports, 2006; 58(1): 30.
Annemans L, Moeremans K, Lamotte M, Garcia Conde J, Van Den Berg H, Myint H, et al. Pan-European multicentre economic evaluation of recombinant urate oxidase (rasburicase) in prevention and treatment of hyperuricaemia and tumour lysis syndrome in haematological cancer patients. Supportive care in cancer, 2003; 11(4): 57-249.