환자표본자료를 이용한 간세포암종 환자의 의료이용 특성 및 치료별 의료비용 분석
Analysis of Medical Use and Treatment Costs of Hepatocellular Carcinoma Patients Using National Patient Sample Data
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service–National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.
Abstract
Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service–National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.
참고문헌 (29)
- "Cause of Death Statistics"[URL]
- Korean Liver Cancer Association (KLCA) and National Cancer Center (NCC, "2018 Korean Liver Cancer Association–National Cancer Center Korea Practice Guidelines for the Management of Hepatocellular Carcinoma", Korean Journal of Radiology, 20(7), pp.1042~1113 (2019), 대한영상의학회[DOI]
- Fitzmaurice C, "Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017: A systematic analysis for the global burden of disease study", JAMA Oncol, 5(12), pp.1749~1768 (2019)
- "White Paper on Liver Diseases in Korea"[URL]
- European Association for the Study of the Liver, "EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma", J Hepatol, 56(4), pp.908~943 (2012)
- Forner A, "Hepatocellular carcinoma", Lancet, 391(10127), pp.1301~1314 (2018)
- Khalaf N, "Natural History of Untreated Hepatocellular Carcinoma in a US Cohort and the Role of Cancer Surveillance", Clin Gastroenterol Hepatol, 15(2), pp.273~281 (2017)
- Andersson KL, "Cost effectiveness of alternative surveillance strategies for hepatocellular carcinoma in patients with cirrhosis", Clin Gastroenterol Hepatol, 6(12), pp.1418~1424 (2008)
- Cadier B, "Early detection and curative treatment of hepatocellular carcinoma : A cost-effectiveness analysis in France and in the United States", Hepatology, 65(4), pp.1237~1248 (2017)
- Goossens N, "Cost-effectiveness of risk score-stratified hepatocellular carcinoma screening in patients with cirrhosis", Clin Transl Gastroenterol, 8(6), pp.e101~ (2017)
- Kondili LA, "Modeling cost-effectiveness and health gains of a"universal"versus"prioritized"hepatitis C virus treatment policy in a real-life cohort", Hepatology, 66(6), pp.1814~1825 (2017)
- Tzartzeva K, "Surveillance imaging and alpha fetoprotein for early detection of hepatocellular carcinoma in patients with cirrhosis : A meta-analysis", Gastroenterology, 154(6), pp.1706~1718.e1 (2018)
- Yang JD, "Impact of surveillance for hepatocellular carcinoma on survival in patients with compensated cirrhosis", Hepatology, 68(1), pp.78~88 (2018)
- Kim HL, "Magnetic resonance imaging is cost-effective for hepatocellular carcinoma surveillance in high-risk patients with cirrhosis", Hepatology, 69(4), pp.1599~1613 (2019)
- 김영애, "Socioeconomic Burden of Cancer in Korea from 2011 to 2015", Cancer Research and Treatment, 52(3), pp.896~906 (2020), 대한암학회[DOI]
- Kim L, "A guide for the utilization of health insurance review and assessment service national patient samples", Epidemiol Health, 36, pp.e2014008~ (2014)
- Study on the operational definition of disease based on national health insurance claim data. 2017 NHIS Ilsan hospital institute health insurance & clinical research, "Kim DW", 88~, pp.Report No.: 2017-20-029 (2017)
- Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies : development and validation", J Chronic Dis, 40(5), pp.373~383 (1987)
- Quan H, "Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data", Med Care, 43(11), pp.1130~1139 (2005)
- 김진희, "2005년 암의 경제적 비용부담 추계", 예방의학회지, 42(3), pp.190~198 (2009), 대한예방의학회
- 김지훈, "2018년 대한간암학회-국립암센터 간세포암종 진료 가이드라인 소개: 2014년 가이드라인과 달라진 점을 중심으로", 대한소화기학회지, 74(2), pp.101~109 (2019), 대한소화기학회[DOI]
- Lang K, "The burden of illness associated with hepatocellular carcinoma in the United States", J Hepatol, 50(1), pp.89~99 (2009)
- White LA, "Medical care costs and survival associated with hepatocellular carcinoma among the elderly", Clin Gastroenterol Hepatol, 10(5), pp.547~554 (2012)
- Nguang SH, "Treatment and cost of hepatocellular carcinoma : A population-based cohort study in Taiwan", Int J Environ Res Public Health, 15(12), pp.2655~ (2018)
- Park JW, "Global patterns of hepatocellular carcinoma management from diagnosis to death : the BRIDGE Study", Liver Int, 35(9), pp.2155~2166 (2015)
- Bargellini I, "Trends in utilization of transarterial treatments for hepatocellular carcinoma : results of a survey by the Italian Society of Interventional Radiology", Cardiovasc Intervent Radiol, 37(2), pp.438~444 (2014)
- 홍영미, "Trends and Patterns of Hepatocellular Carcinoma Treatment in Korea", Journal of Korean Medical Science, 31(3), pp.403~409 (2016), 대한의학회
- "The Impact of the national Liver Cancer Surveillnace Program on the Early Detection, Mortality and Medical cost" (2016)[URL]
- "Costing methods in Healthcare"[URL]