|000||00000nam c2200205 c 4500|
|008||041127s2004 ulka m AC 000c kor|
|040||▼a 211009 ▼d 211009 ▼c 211009|
|085||▼a 0510 ▼2 KDCP|
|090||▼a 0510 ▼b 6H3 ▼c 32|
|100||1||▼a 김보연 ▼g 金俌然|
|245||1 0||▼a 항암제 사용의 규모와 관련요인의 연구 : ▼b 위암, 폐암, 유방암을 대상으로 = ▼x Study of scale and relevant factors in the use of chemotherapy - focusing on stomach cancer, lung cancer, breast cancer / ▼d 金俌然|
|260||▼a 서울 : ▼b 고려대학교, ▼c 2004|
|300||▼a viii, 98 p. : ▼b 삽화 ; ▼c 26 cm|
|500||▼a 지도교수: 윤석준|
|502||0||▼a 학위논문(석사)-- ▼b 고려대학교 보건대학원: ▼c 보건정책 및 병원관리학과, ▼d 2004.8|
|653||▼a 암약제비 증가요인 ▼a 약제비 변이 ▼a 위암 ▼a 폐암 ▼a 유방암진료비 ▼a Breast cancer ▼a Lung cancer ▼a Stomach cancer ▼a variation of drug expenditure at medical site ▼a medical fee ▼a cancer treatment|
|900||1 0||▼a Kim, Bo Yeon, ▼e 저|
|900||1 0||▼a 윤석준, ▼e 지도교수|
Cancer is the first common factor among death causes in Korea and the morbidity rate is rising steadily. Among cancer treatment expenses, the highest one is the drug expenditure, which is expected to grow rapidly due to the development of high priced anticancer drugs in the 2000s. And it has become necessary to be managed from a national point of view because hundreds of combination regimen has designed and many treatment method are conducted. Moreover, Cancer is variable in treatment compared to other diseases. With review of domestic thesis published, which is related to tumors, It is very hard to find out any definite results concerning the management method using the anticancer drugs served by medical providers such as specialist, hospital, clinic and the medical fees for cancer treatment and the increasing reasons of drug expenditure for anticancer drugs. Therefore, by clarifying the factors which are related to these fields definitely, we have conducted a study on the application status of anticancer drugs and its expenditures. With regardto this review, we consider that we can utilized it as a basic data for medical policies in the field of Health and Medical service. This study has targeted to the stomach cancer, lung cancer and breast cancer among some solid-types cancers. they have a large share of drug expenditure against their medical fees on the basis of the minute description for treatment applying to the HIRA ( Health Institute Review Agency ) during current 3 years. To evaluate the factor analysis influencing the increasingof drug expenditures in cancer treatment by Medical providers ( medical sites ), the study has conducted the treatment analysis on application status of anticancer drugs and their variation by year and disease respectively and the multivariate regression analysis was implemented on characteristics of medical service providers. Besides, by analyzing the treatment details on same scale medical sites and on specific departments in a same medical site. To clarify the variation in each sites and each specialists, we are focusing on drug expenditures and treatment details. The conclusion is as follows. Firstly, while patients undergoing operation and anticancer drugs medication has all increased. Those who do not receive the medical treatment has decreased. The ratio of drug expenditure against medical fees is by 41.8% , rate of expenses for anticancer per drug expenditures is by 62.8%. Especially, the second-line cancer drugs has increased by 22%. Totally, the medical fees for cancer treatment has increased to 38%, While drug expenditures has increased to 60%. This means that the increasing rate of anticancer drugs doubles that of Medical fees, Patients who receive anticancer drug has paid more than two times for the treatment than those who didn't. Among the dead, patient who died within 3 months from the day of first diagnosis, the stomach cancer appeared by 40%, the lung cancer was by 45% and the breast cancer was by 29%. Meanwhile, the treatment fees of those patients was 26.1% on average, that of patients who died within 6 months is by 49.0%. Even though they bore high medical fees for cancer treatment in a short time, But, they died within 6 months. Secondly, by analyzing a recent aspect of anticancer drugs prescription and the actual condition of using them according to the characters of medical service providers, we found out that there are significant differencesin use of anticancer drug by region, medical sites, scale of sites, specialties and oncology section. People who received anticancer drugs and their overall expenses has rapidly increased year by year, and the ratio of anticancer drugs is by 63% of total drug expenditures, even though we didn't reflect the non-insurance parts as an additional other costs. If we take into consideration that amount of service can lead to the expense increase and the physical side effects, we think it is hard to tell which treatment would be more appropriate choice clinically only with the quantity (mainly, expenses) of given medical resources. Moreover, in many of foreign countries, A “Standard diagnosis principle” for each diseases has commonly established, and then, from this study, we found out that there are somewhat differences in the choice of anticancer drug and the medical expenses depending on medical service providers. Accordingly, we propose that it needs to establish a scientific and objective Standard diagnosis principle for proper cancer treatment. This study has analyzed only the quantity of resources throughthe process of diagnosis and actually could not reflect the outcome of diagnosis. So, it is necessary to perform an in-depth study reflecting the reason of different uses of anticancer drugs according to diagnosis subjects within the same medical site.
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