title: [Refining the French system of cost assessment for oncology patients following chemotherapy].
abstract: The aim of this study was to check the clinical predictive variables of the variance of the total cost by GHM for patients undergoing chemotherapy. 10 different hospitals registered 537 hospital stays and 1,535 day care sessions. The initial disease, metastases, other pathologies, participation to randomised trial were recorded. Each day health status, pain, stage of the protocol and the drugs, use of catheter, pump or chamber implant were noted. Work was measured separately for physicians and nurses per 24 hours using a visual analogy scale. Lab tests and drugs were recorded for each patient. The cost of the drugs explain 98% of the variance of the total cost for the day care and 50% for the hospitalisations. For the latter, beside the cost of drugs, the length of stay, labor, initial disease, age, pain and associated pathology are predictive variables. According to this results, we conclude that the drugs for chemotherapy should be paid separately. No other change should be made for day care. DRG for hospitalized patients should take into account initial disease, age and pain.
authors.affiliation: Institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94800 Villejuif, France. levy@igr.fr
authors.forename: Christine
authors.initials: C
authors.lastname: Lévy-Piedbois
authors.forename: Laurent
authors.initials: L
authors.lastname: Borella
authors.forename: Philippe
authors.initials: P
authors.lastname: Bergerot
authors.forename: Patrick
authors.initials: P
authors.lastname: Peuvrel
authors.forename: Cristel
authors.initials: C
authors.lastname: Erard
authors.forename: Gérard
authors.initials: G
authors.lastname: Parmentier
authors.forename: Alain
authors.initials: A
authors.lastname: Ravaud
authors.forename: Béatrice
authors.initials: B
authors.lastname: Trombert Paviot
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Armand
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Rodrigues
mesh_terms: D000553:Ambulatory Care / Q000191:economics*; D000970:Antineoplastic Agents / Q000191:economics* / Q000627:therapeutic use; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics*; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D009369:Neoplasms / Q000188:drug therapy / Q000191:economics*
chemical_list: D000970:Antineoplastic Agents