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Author: Julien Guignet
Publisher: Editions Universitaires Europeennes
ISBN: 9783841799258
Category :
Languages : de
Pages : 140
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Book Description
L'objectif de cette these est l'analyse des couts de prise en charge des patientes atteintes d'un cancer du sein. Le point de vue adopte est celui de l'assurance maladie. Les couts des hospitalisations sont determines a partir des bases de donnees d'activite des etablissements et ceux des soins de ville a partir des bases de remboursements de l'assurance maladie. Un recueil dans les dossiers a fiabilise les donnees. Le mode de facturation du secteur public a ete applique a toutes les hospitalisations. La recherche des determinants significatifs a porte sur l'exposition au reseau, les caracteristiques des patientes, de leur cancer et de leur parcours de soins. Le cout moyen de prise en charge est de 15273 (et 5056 ). Les hospitalisations representent 82,5% de ce cout, les soins de ville 16,9% et le reseau 0,6%. La radiotherapie, la chimiotherapie, l'hormonotherapie, une comorbidite, un stade clinique de mauvais pronostic et le type de filiere "privee" augmentent les couts. Ces estimations mettent a disposition des elements nouveaux de comparaison avec les donnees de la litterature. Cette methode, combinant plusieurs bases, pourrait etre transposable a d'autres pathologies.
Author: Julien Guignet
Publisher: Editions Universitaires Europeennes
ISBN: 9783841799258
Category :
Languages : de
Pages : 140
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Book Description
L'objectif de cette these est l'analyse des couts de prise en charge des patientes atteintes d'un cancer du sein. Le point de vue adopte est celui de l'assurance maladie. Les couts des hospitalisations sont determines a partir des bases de donnees d'activite des etablissements et ceux des soins de ville a partir des bases de remboursements de l'assurance maladie. Un recueil dans les dossiers a fiabilise les donnees. Le mode de facturation du secteur public a ete applique a toutes les hospitalisations. La recherche des determinants significatifs a porte sur l'exposition au reseau, les caracteristiques des patientes, de leur cancer et de leur parcours de soins. Le cout moyen de prise en charge est de 15273 (et 5056 ). Les hospitalisations representent 82,5% de ce cout, les soins de ville 16,9% et le reseau 0,6%. La radiotherapie, la chimiotherapie, l'hormonotherapie, une comorbidite, un stade clinique de mauvais pronostic et le type de filiere "privee" augmentent les couts. Ces estimations mettent a disposition des elements nouveaux de comparaison avec les donnees de la litterature. Cette methode, combinant plusieurs bases, pourrait etre transposable a d'autres pathologies.
Author: Benoît Delavelle
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Dix à 15% des cancers du sein sont métastatiques d'emblée et environ 20 à 25% des cancers du sein deviendront métastatiques, représentant des milliers de patients. L'apparition de nouveaux traitements comme les thérapies ciblées ont positionné l'évaluation médico économique comme un point central du remboursement des prises en charge de ce type de cancer. Aussi, il nous a apparu opportun de réaliser une étude des coûts de prise en charge des cancers du sein métastatique dans un Centre de Lutte Contre le Cancer durant la période 2008-2015. A partir de l'étude ESME, étude observationnelle rétrospective en vie réelle, mise en place par UNICANCER, 716 patients ont été inclus dans notre étude et répartis en 5 groupes en fonction des marqueurs tumoraux présents sur la tumeur initiale et donc en fonction de la stratégie thérapeutique. Une description de la prise en charge des cancers du sein métastatiques a été réalisée en termes de nombres de séjours, de molécules onéreuses administrées mais aussi du nombre des chimiothérapies orales et des hormonothérapies prescrites à partir de la prise en charge initiale de la maladie métastatique. Le coût global de la prise en charge d'un cancer du sein métastatique par patient et par an est en moyenne de 12 338€. Les différences de coûts étaient notables entre les groupes avec un coût global moyen de prise en charge qui était bien supérieur pour les patients ayant des récepteurs HER 2 positifs avec des coûts moyen entre 26 409€ et de 30 939 € en comparaison avec les patients ayant des récepteurs Her2 négatifs (entre 9 305 et 16 567 euros). Ces différences s'expliquaient en grande partie par le coût des molécules onéreuses notamment les anti-HER2. Ces résultats sont du même ordre de grandeur que d'autres études, qui concluaient à des coûts compris entre 29 995 € et 39 607 €, en fonction de la méthodologie de calcul de coûts employée ainsi que des caractéristiques des patientes.
Author: Julien Guignet (médecin)
Publisher:
ISBN:
Category :
Languages : fr
Pages : 252
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Book Description
Author: Monica Castiglione
Publisher: Springer Science & Business Media
ISBN: 0387751157
Category : Medical
Languages : en
Pages : 483
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Book Description
Adjuvant treatment is administered prior to or as follow up to surgical procedures for breast cancer. Proven success in using medical therapies allowing for breast conserving procedures or reducing risk of occurrence. Although there has been much progress towards a cure, including the introduction of new targeted therapies, metastasizing cancer remains highly incurable.
Author: Monica Morrow
Publisher: PMPH-USA
ISBN: 9781550092608
Category : Breast
Languages : en
Pages : 328
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Book Description
Managing Breast Cancer Risk is a single source for information needed by primary care physicians, nurses, gynecologists, as well as oncologic specialists who deal with women who are concerned about breast cancer. Its purpose is to bring together a multidisciplinary group of experts to address breast cancer risk in a clinically meaningful way. Chapters providing detailed information on individual risk factors are accompanied by a discussion of models, which integrate multiple factors for a more complete assessment of risk. Traditional strategies for risk management, including surveillance and prophylactic surgery, are reviewed, and the data on newer techniques such as ductal lavage and screening with magnetic resonance is presented. The rational for chemoprevention with selective estrogen receptor modulators (SERMS) is discussed, and the evidence for tamoxifen as a chemopreventative is updated. The potential for chemoprevention with newer SERMS and the aromatase inhibitors is reviewed. Finally, the critical (and often ignored) areas of quality of life and symptom management are addressed.
Author: Alan D. Lopez
Publisher: World Bank Publications
ISBN: 0821362631
Category : Medical
Languages : en
Pages : 511
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Book Description
Strategic health planning, the cornerstone of initiatives designed to achieve health improvement goals around the world, requires an understanding of the comparative burden of diseases and injuries, their corresponding risk factors and the likely effects of invervention options. The Global Burden of Disease framework, originally published in 1990, has been widely adopted as the preferred method for health accounting and has become the standard to guide the setting of health research priorities. This publication sets out an updated assessment of the situation, with an analysis of trends observed since 1990 and a chapter on the sensitivity of GBD estimates to various sources of uncertainty in methods and data.
Author: Luigi Solbiati
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 442
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Book Description
A practical text aimed at the diagnostic radiologist and ultrasonographer, which describes and evaluates the applications of high frequency imaging in clinical diagnosis. An introductory chapter covers technical aspects of high-frequency imaging and subsequent chapters cover ulatasound appearances.
Author: J. Zander
Publisher: Springer Science & Business Media
ISBN: 3642701922
Category : Medical
Languages : en
Pages : 384
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Book Description
March 23 and 24, 1983 saw the fIrst international symposium held under the auspices of the Wilhelm Vaillant Foundation for the Advancement of Pro phylactic Medicine in the I. Frauenklinik der Ludwig Maximilians Univer sitiit Miinchen. This symposium was concerned with Advances in Early Detection and Treatment of Breast Cancer and brought together patholo gists, gynecologists, and radiologists from Denmark, England, France, Italy, Sweden, Switzerland, the German Democratic Republic, and the Federal Republic of Germany. The fIrst session dealt with problems concerned with the biology, patho genesis, and histopathology of early carcinoma of the breast, with special reference to the clinical aspects. The second session was taken up with topi cal developments in the early diagnosis of breast carcinoma and indicated the present limitations of early diagnosis. In the third session the latest results of the experiences by groups working on the treatment of early carci noma of the breast in France, the United Kingdom, Italy, the United States of America, and the Federal Republic of Germany were discussed. The main emphasis lay on conservative treatment methods with complete or partial preservation of the breast. These vary quite widely. Some of the conclusions presented on the basis of long-term clinical studies must be regarded as signifIcant breakthroughs, and at the stage these have reached they must no longer be overlooked. The symposium has highlighted numerous unsolved problems and made it clear that conflicting opinions abound.
Author: Oreste Gentilini
Publisher: Springer Nature
ISBN: 3030247627
Category : Medical
Languages : en
Pages : 218
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Book Description
This contributed book covers all aspects concerning the clinical scenario of breast cancer in young women, providing physicians with the latest information on the topic. Young women are a special subset of patients whose care requires dedicated expertise. The book, written and edited by internationally recognized experts who have been directly involved in the international consensus guidelines for breast cancer in young women, pays particular attention to how the disease and its planned treatment can be effectively communicated to young patients. Highly informative and carefully structured, it provides both theoretical and practice-oriented insight for practitioners and professionals involved in the different phases of treatment, from diagnosis to intervention, to follow-up – without neglecting the important role played by prevention.
Author: Ulrich Bick
Publisher: Springer Science & Business Media
ISBN: 3540784500
Category : Medical
Languages : en
Pages : 222
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Book Description
Digital Radiography has been ? rmly established in diagnostic radiology during the last decade. Because of the special requirements of high contrast and spatial resolution needed for roentgen mammography, it took some more time to develop digital m- mography as a routine radiological tool. Recent technological progress in detector and screen design as well as increased ex- rience with computer applications for image processing have now enabled Digital Mammography to become a mature modality that opens new perspectives for the diag- sis of breast diseases. The editors of this timely new volume Prof. Dr. U. Bick and Dr. F. Diekmann, both well-known international leaders in breast imaging, have for many years been very active in the frontiers of theoretical and translational clinical research, needed to bring digital mammography ? nally into the sphere of daily clinical radiology. I am very much indebted to the editors as well as to the other internationally rec- nized experts in the ? eld for their outstanding state of the art contributions to this v- ume. It is indeed an excellent handbook that covers in depth all aspects of Digital Mammography and thus further enriches our book series Medical Radiology. The highly informative text as well as the numerous well-chosen superb illustrations will enable certi? ed radiologists as well as radiologists in training to deepen their knowledge in modern breast imaging.
