肝癌患者罹病成本與其相關因子之探討：以某醫學中心患者為例

Morbidity Costs and Associated Factors of Patients with Hepatocellular Carcinoma from a Medical Center

吳季倫(Chi-Lun Wu) ； 楊銘欽(Ming-Chin Yang)

《中華公共衛生雜誌》 17卷2期 (1998/04) Pp. 148-157

https://doi.org/10.6288/CJPH1998-17-02-08

摘要

肝癌為台灣十種常見惡性腫瘤之一，於近年來已成為癌症死因之首位。罹患肝癌後，各種醫療費用與相關支出，以及患者與親友潛在的生產力損失，對個人、家庭乃至社會之經濟影響甚鉅。
本研究以社會觀點估計某醫學中心229位受訪肝癌患者自確診後至受訪日期或死亡日期之罹病成本（包括直接成本與間接成本）。直接成本包括患者自付及保險支付之相關醫療費用；而間接成本則包括交通費用、時間成本與其他支出。研究結果發現罹病成本、直接成本與間接成本之總平均值分別為450,000元、250,000元及210,000元；肝癌第二期患者之平均值分別為430,000元、250,000元及180,000元；而肝癌第三期以上患者之平均值分別為510,000元、230,000元及280,000元。間接成本視患者期別不同，約佔罹病成本之40%至50%，並且時間成本部份即佔間接成本之90%左右。而無論是直接成本、間接成本或罹病成本，醫療服務利用情形皆與各項成本成正相關。此外，確診前薪資較高之患者，其間接成本與罹病成本亦較高。

關鍵字

肝癌 ； 罹病成本 ； 直接成本 ； 間接成本

並列摘要

Hepatocellular carcinoma (HCC) is one of ten common cancers in Taiwan and has been the leading cause of death among cancer patients in recent years. Once contracted with HCC, enormous cost of medical care, such as expenditures associated with care seeking and the potential loss in productivity, will have tremendous economic impact on the patient, his/her family and the society.
Based on social perspective, this study estimated morbidity costs (including direct costs and indirect costs) of 229 HCC patients from a medical center. The costs estimated were occurred from the diagnosis date to the date of responding our questionnaire or the death date. Direct costs refer to medical care expenditures, and indirect costs include transportation fee, time cost and others. Disregard patients stages of HCC, the average direct, indirect and morbidity costs were about NT $250,000, NT $210,000, and NT $450,000, respectively. For patients of HCC stage Ⅱ, the average direct, indirect and morbidity costs were about NT $250,000, NT $180,000, and NT $430,000, and for patients over HCC stage Ⅲ were about NT $230,000, NT $280,000, and NT $510,000, respectively. About 40% to 50% of morbidity costs were attributable to indirect costs, and 90% of indirect costs were attributable to time cost. The direct, indirect and morbidity costs were positively associated with medical care utilized. Furthermore, the indirect and morbidity costs were associated with the salaries of the patients before the diagnoses were confirmed.

並列關鍵字

hepatocellular carcinoma ； morbidity cost ； direct cost ； indirect cost