Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
The Out of Pocket Cost of Outpatient Breast Cancer in Konya, Turkey
Ayaktan Tedavi Gören Meme Kanseri Hastalarının Cepten Harcama Maliyetleri Konya, Türkiye
Sümeyra TEMURTAŞa, Aydan YÜCELERb, Nimetcan MEHMETc
aDepartment of Healthcare Management, Konya Necmettin Erbakan University Institute of Health Science, Konya, TURKEY
bDepartment of Healthcare Management, Konya Necmettin Erbakan University Faculty of Health Science, Konya, TURKEY
cDepartment of Public Health, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, TURKEY
Turkiye Klinikleri J Health Sci. 2021;6(3):618-29
doi: 10.5336/healthsci.2020-78573
Article Language: EN
Full Text
ABSTRACT
 Objective: Breast cancer is the most common type of cancer in women with increasing incidence and prevalence rates in the world and in our country, and it is inevitable that the costs associated with breast cancer create an economic burden for both states and patients. For this reason, in our study, it was aimed to determine the illness and disease-related out-of-pocket healthcare costs of patients receiving outpatient treatment due to breast cancer. Material and Methods: Our study, which is a quantitative study, also shows the feature of being a study in the field of health economics. The sample of the study consisted of 86 patients who receive outpatient treatment diagnosed with breast cancer (receiving chemotherapy and radiotherapy) in Necmettin Erbakan University Meram Medical Faculty Hospital. Results: According to the data obtained from Konya Provincial Health Directorate Public Health Presidency, there were 444 confirmed breast cancer patients in Konya, 434 of which are women and 10 of which are men inn 2016. In the study, one-year out-of-pocket spending of breast cancer patients was calculated as 5,616 TL. Conclusion: The overall cost of breast cancer patients in Konya in 2018 was calculated as 2,493,876.98 TL, this cost was 2,437,708.56 TL for female breast cancer patients and 56,168.4 TL for male breast cancer patients. A detailed examination of other cost items will be a guide for the costs of breast cancer patients and for reducing these costs.

Keywords: Breast neoplasms; health economics; health expenditures
ÖZET
 Amaç: Meme kanseri, dünyada ve ülkemizde artan insidans ve prevalans oranlarıyla kadınlarda en çok görülen kanser türüdür ve meme kanserine bağlı maliyetlerin, hem devletler hem de hastalar için ekonomik yük oluşturması kaçınılmazdır. Bu sebeple çalışmamızda, meme kanserine bağlı ayaktan tedavi gören hastaların, hastalık ve hastalıkla ilişkili cepten sağlık ödeme maliyetlerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Nicel bir çalışma olan çalışmamız, aynı zamanda sağlık ekonomisi alanında bir çalışma olma özelliği de göstermektedir. Çalışmanın örneklemini Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi'nde ayaktan tedavi gören (kemoterapi ve radyoterapi alan) meme kanseri tanısı almış 86 hasta oluşturmaktadır. Bulgular: Konya Valiliği İl Sağlık Müdürlüğü Halk Sağlığı Başkanlığından elde edilen verilere göre Konya ilinde, 2016 yılında 434 kadın ve 10 erkek olmak üzere toplamda 444 meme kanseri hastası bulunmaktadır. Yürütülen çalışmada meme kanseri hastalarının meme kanserine bağlı 1 yıllık cepten harcamaları 5.616 TL olarak hesaplanmıştır. Sonuç: Konya ili geneli 2018 yılı için ise meme kanseri hastalarının toplam maliyeti 2.493.876,98 TL, kadın meme kanseri hastaları için 2.437.708,56 TL ve erkek meme kanseri hastaları için ise 56.168,4 TL olarak hesaplanmıştır. Diğer maliyet kalemlerinin ayrıntılı incelenmesi, meme kanseri hastalarının maliyetleri ve bu maliyetlerin azaltılması konusunda yol gösterici olacaktır.

Anahtar Kelimeler: Meme kanseri; sağlık ekonomisi; sağlık masrafları
REFERENCES:
  1. Koçak S, Çelik L, Özbaş S, Dizbay Sak S, Tükün A, Yalçın B. Meme kanserinde risk faktörleri, riskin değerlendirilmesi ve prevansiyon: İstanbul 2010 konsensus raporu. [Risk factors in breast cancer, risk assessment and prevention: 2010 İstanbul consensus meeting report]. The Journal of Breast Health. 2011;7(2):47-67. [Link] 
  2. Deloumeaux J, Gaumond S, Bhakkan B, Manip M'Ebobisse N, Lafrance W, Lancelot P, et al. Incidence, mortality and receptor status of breast cancer in African Caribbean women: data from the cancer registry of Guadeloupe. Cancer Epidemiol. 2017;47:42-7. [Crossref]  [PubMed] 
  3. Merrill RM, Sloan A. Risk-adjusted female breast cancer incidence rates in the United States. Cancer Epidemiol. 2012;36(2):137-40. [Crossref]  [PubMed] 
  4. Yabroff KR, Lund J, Kepka D, Mariotto A. Economic burden of cancer in the United States: estimates, projections, and future research. Cancer Epidemiol Biomarkers Prev. 2011;20(10):2006-14. [Crossref]  [PubMed]  [PMC] 
  5. Dikshit RP, Yeole BB, Nagrani R, Dhillon P, Badwe R, Bray F. Increase in breast cancer incidence among older women in Mumbai: 30-year trends and predictions to 2025. Cancer Epidemiol. 2012;36(4):e215-20. [Crossref]  [PubMed] 
  6. Youlden DR, Cramb SM, Dunn NA, Muller JM, Pyke CM, Baade PD. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer Epidemiol. 2012;36(3):237-48. [Crossref]  [PubMed] 
  7. Foster TS, Miller JD, Boye ME, Blieden MB, Gidwani R, Russell MW. The economic burden of metastatic breast cancer: a systematic review of literature from developed countries. Cancer Treat Rev. 2011;37(6):405-15. [Crossref]  [PubMed] 
  8. Meneses K, Azuero A, Hassey L, McNees P, Pisu M. Does economic burden influence quality of life in breast cancer survivors? Gynecol Oncol. 2012;124(3):437-43. [Crossref]  [PubMed]  [PMC] 
  9. Rashid N, Koh HA, Baca HC, Lin KJ, Malecha SE, Masaquel A. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system. Breast Cancer: Targets and Therapy. 2016;8:173-81. [Crossref] 
  10. Yin W, Horblyuk R, Perkins JJ, Sison S, Smith G, Snider JT, et al. Association between breast cancer disease progression and workplace productivity in the United States. J Occup Environ Med. 2017;59(2):198-204. [Crossref]  [PubMed] 
  11. Jain M, Mukherjee K. Economic burden of breast cancer to the households in Punjab, India. International Journal of Medicine and Public Health. 2016;6(1):13-8. [Crossref] 
  12. Özmen V. Türkiye'de meme kanseri. [Breast cancer in Turkey]. Turkiye Klinikleri J Gen Surg-Special Topics. 2013;6(2):1-6. [Link] 
  13. Türkyılmaz M, Hacıkamiloğlu E, Baran Deniz E, Boztaş G, Dündar S, Kavak Ergün A, et al. Türkiye Kanser İstatistikleri 2015. İlter H, Keskinkılıç B, editörler. Ankara: TC. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü; 2018. [Link] 
  14. Daroudi R, Akbari Sari A, Nahvijou A, Kalaghchi B, Najafi M, Zendehdel K. The economic burden of breast cancer in Iran. Iran J Public Health. 2015;44(9):1225-33. [PubMed]  [PMC] 
  15. Vyas A, Madhavan SS, Sambamoorthi U, Pan XL, Regier M, Hazard H, et al. Healthcare utilization and costs during the initial phase of care among elderly women with breast cancer. J Natl Compr Canc Netw. 2017;15(11):1401-9. [Crossref]  [PubMed]  [PMC] 
  16. Barron JJ, Quimbo R, Nikam PT, Amonkar MM. Assessing the economic burden of breast cancer in a US managed care population. Breast Cancer Res Treat. 2008;109(2):367-77. [Crossref]  [PubMed] 
  17. Jagsi R, Pottow JA, Griffith KA, Bradley C, Hamilton AS, Graff J, et al. Katz SJ, Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. J Clin Oncol. 2014;20;32(12):1269-76. [Crossref]  [PubMed]  [PMC] 
  18. Kim YA, Oh IH, Yoon SJ, Kim HJ, Seo HY, Kim EJ, et al. The economic burden of breast cancer in Korea from 2007-2010. Cancer Res Treat. 2015;47(4):583-90. [Crossref]  [PubMed]  [PMC] 
  19. Pisu M, Azuero A, Benz R, McNees P, Meneses K. Out-of-pocket costs and burden among rural breast cancer survivors. Cancer Med. 2017;6(3):572-81. [Crossref]  [PubMed]  [PMC] 
  20. Badak B. Meme kanserinin kosta metastazı: olgu sunumu. [Breast cancer with rib bone metastasis: case report]. Bozok Med J. 2017;7(1);105-7. [Link] 

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