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癌前病變診斷對口腔癌醫療費用之影響–以台灣健保資料庫為例
Other Title
The influence of oral precancerous lesion diagnosis on expenditure in patients with oral cancer: A comparative study using Taiwan's National Health Insurance Research Database
Type
thesis
Date Issued
2016-06-08
Author(s)
易志華
Advisor
許怡欣
Subjects
系所名稱：醫務管理學研究所
Description
學位別：碩士
語文別：英文
指導教授：許怡欣
共同指導教授：
口試委員：許玫玲;陳金淵
中文關鍵字：口腔癌，癌前病變，口腔癌前病變，國民保險，財政負擔。
英文關鍵字：Oral cancer, Oral precancerous lesions, Oral premalignant lesions, National Health Insurance, Healthcare expenditure, Financial burden.
語文別：英文
指導教授：許怡欣
共同指導教授：
口試委員：許玫玲;陳金淵
中文關鍵字：口腔癌，癌前病變，口腔癌前病變，國民保險，財政負擔。
英文關鍵字：Oral cancer, Oral precancerous lesions, Oral premalignant lesions, National Health Insurance, Healthcare expenditure, Financial burden.
Abstract
Introduction: Oral cancer is a major public health problem. In 2012, the annual incidence of was around 300,000 and mortality was about 145,000. Majority of the oral cancer patients are diagnosed during their advanced stage and they are not just extremely expensive to treat but also have considerably worse outcome.
In Taiwan, oral cancer is the leading cause of death in men between 25 to 44 years of age. The survival rate for the advanced stage is < 20% whereas for early stage is >75%, this suggests the importance of oral precancerous lesion diagnosis in reducing oral cancer mortality and the burden of aggressive treatment expenditure it puts on the patients and the government.
Objective: The aim of this study is to estimate the mean total expenditure in outpatient department and inpatient department in oral cancer patients followed for 1 year from the date of diagnosis of oral cancer and analyzing the variations in the mean expenditure by the presence or absence of oral precancerous lesion diagnosis and other related factors.
Methods: This is a retrospective cohort study based on 2 million people randomly selected from Taiwan’s National Health Insurance Research Database. A total of 1837 new oral cancer patients aged ≥ 20 years were diagnosed from 2008 to 2010. The patients were then divided into two groups according to the presence of an earlier oral precancerous lesion diagnosis (OPLD): oral cancer patients with OPLD (Group A) and oral cancer patients without OPLD (Group B). Mean total expenditure for these two groups were then calculated and compared.
Results: It was found that the mean total expenditure in Group B was higher in both outpatient department (OPD) (118,221 NTD) and inpatient department (IPD) (224,277 NTD). In 2010, females had higher mean total OPD (213,810 NTD) and IPD (383,041 NTD) expenditure in Group A.
Conclusion: In Taiwan, oral cancer is supposed to be the third most expensive cancer to treat. The result of this analysis can provide useful information to healthcare providers and decision makers in understanding the economic burden of oral cancer. The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.
In Taiwan, oral cancer is the leading cause of death in men between 25 to 44 years of age. The survival rate for the advanced stage is < 20% whereas for early stage is >75%, this suggests the importance of oral precancerous lesion diagnosis in reducing oral cancer mortality and the burden of aggressive treatment expenditure it puts on the patients and the government.
Objective: The aim of this study is to estimate the mean total expenditure in outpatient department and inpatient department in oral cancer patients followed for 1 year from the date of diagnosis of oral cancer and analyzing the variations in the mean expenditure by the presence or absence of oral precancerous lesion diagnosis and other related factors.
Methods: This is a retrospective cohort study based on 2 million people randomly selected from Taiwan’s National Health Insurance Research Database. A total of 1837 new oral cancer patients aged ≥ 20 years were diagnosed from 2008 to 2010. The patients were then divided into two groups according to the presence of an earlier oral precancerous lesion diagnosis (OPLD): oral cancer patients with OPLD (Group A) and oral cancer patients without OPLD (Group B). Mean total expenditure for these two groups were then calculated and compared.
Results: It was found that the mean total expenditure in Group B was higher in both outpatient department (OPD) (118,221 NTD) and inpatient department (IPD) (224,277 NTD). In 2010, females had higher mean total OPD (213,810 NTD) and IPD (383,041 NTD) expenditure in Group A.
Conclusion: In Taiwan, oral cancer is supposed to be the third most expensive cancer to treat. The result of this analysis can provide useful information to healthcare providers and decision makers in understanding the economic burden of oral cancer. The clinical management of advanced oral cancer is strongly associated with higher costs. Although the ideal would be to prevent cancer, the combination of high-risk screening, early diagnosis and early treatment seems the most efficient way to reduce costs, and most importantly, prolong life.