title: [Medical transfers in pediatric oncology. Reflections apropos of economic, technical and ethical problems (Oran 1977-1983)].
abstract: In an underdeveloped country such as Algeria [20 million inhabitants, 2,140 US Dollars per capita gross national product (GNP)], satisfying a high level of health demand is difficult both in primary care and hospital. Limited facilities (hospital beds 2.3%; physicians 1:2,500; public health expenditure: 2% of GNP) combined with demographic pressure (population under 15 years of age: 47%) further compromise medical benefits. Qualitatively severe diseases such as pediatric cancers cannot be wholly managed locally. Thus administrative regulations permit sending patients with such situations abroad. We tested the feasibility of managing locally to a great extent (radiotherapy excepted) pediatric cancers. For leukemias and lymphomas, actuarial life expectancies corresponded to middle values of internationally published data. Cost-benefit estimations seemed good compared with other severe diseases managed both locally and abroad. Our present problem deals with balancing oncologic activity (more than 100 new cases a year) within a general pediatric department practice.
mesh_terms: D000462:Algeria; D002648:Child; D004992:Ethics, Medical; D005602:France; D006801:Humans; D008495:Medical Oncology / Q000191:economics; D009369:Neoplasms / Q000191:economics / Q000628:therapy*; D010372:Pediatrics / Q000191:economics; D014187:Transportation of Patients / Q000191:economics / Q000379:methods
vernacular_title: Transferts sanitaires en oncologie pédiatrique. Réflexions à propos de problèmes économiques, techniques et éthiques (Oran 1977-1983).