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PubMed翻訳

Medical Oncologists' Perceptions of Financial Incentives in Cancer Care.

Published date 2012 Dec 26

Medical Oncologists' Perceptions of Financial Incentives in Cancer Care.

癌の特別手当の医学腫瘍学者の認知は、気にかける。

Published date

2012-12-26

Journal

J Clin Oncol. 2012;

Author

Jennifer L Malin, Jane C Weeks, Arnold L Potosky, Mark C Hornbrook, Nancy L Keating

Affiliation

Jennifer L. Malin, Jonsson Comprehensive Cancer Center and David Geffen School of Medicine at University of California at Los Angeles and Greater Los Angeles VA Healthcare System, Los Angeles, CA; Jane C. Weeks, Dana-Farber Cancer Institute; Nancy L. Keating, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Arnold L. Potosky, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; and Mark C. Hornbrook, Center for Health Research, Kaiser Permanente Northwest, Portland, OR.

Abstract

PURPOSEThe cost of cancer care continues to increase at an unprecedented rate. Concerns have been raised about financial incentives associated with the chemotherapy concession in oncology practices and their impact on treatment recommendations. METHODSThe objective of this study was to measure the physician-reported effects of prescribing chemotherapy or growth factors or making referrals to other cancer specialists, hospice, or hospital admissions on medical oncologists' income. US medical oncologists involved in the care of a population-based cohort of patients with lung or colorectal cancer from the Cancer Care Outcomes Research and Surveillance (CanCORS) study were surveyed regarding their perceptions of the impact of prescribing practices or referrals on their income.ResultsAlthough most oncologists reported that their incomes would be unaffected, compared with salaried oncologists, physicians in fee-for-service practice, and those paid a salary with productivity incentives were more likely to report that their income would increase from administering chemotherapy (odds ratios [ORs], 7.05 and 7.52, respectively; both P < .001) or administering growth factors (ORs, 5.60 and 6.03, respectively; both P < .001). CONCLUSIONA substantial proportion of oncologists who are not paid a fixed salary report that their incomes increase when they administer chemotherapy and growth factors. Further research is needed to understand the impact of these financial incentives on both the quality and cost of care.

 

癌治療のPURPOSEThe費用は、先例のない率で増加し続ける。
懸念は、腫瘍学の実践と治療勧告へのそれらの影響で化学療法譲歩と関連した特別手当について上がった。
本研究のMETHODSThe目的は、化学療法または成長因子を処方するか、医学腫瘍学者の収入の上で他の癌の専門医、ホスピスまたは入院への照会をする医師既報告の効果を測定することになっていた。
米国の医学腫瘍学者は、含んだCancer Care Outcomes Researchと検査が大部分の腫瘍学者が報告したそれらのincome.ResultsAlthoughの上で診療所または照会を処方して影響のそれらの認知に関して調査を受けたSurveillance(CanCORS)からの肺または結腸直腸癌にかかった人口に基づいた患者コホート保護下のそれらの収入が影響を受けない、給料の支払いを受ける腫瘍学者と比較して、診療報酬制の医師が、実行する、そして、生産性誘因で給料を支払われる人々が、よりそれらの収入が化学療法を行うことから増加すると報告しそうだった(それぞれオッズ比[ORs]、7.05と7.52;両方のP < .001)または成長因子を投与すること(それぞれORs、5.60と6.03;両方のP < .001)。
彼らが化学療法と成長因子を与えるとき、それらの収入が増加するという固定給報告を支払われない腫瘍学者のCONCLUSIONA相当な比率。
更なる研究は、特性と治療の費用の上でこれらの特別手当の衝撃を理解するために必要である。


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