Amfani da tsadar maganin sankarar nono yana tasiri sosai ta manufar biyan kuɗi
Amfani da tsadar maganin sankarar nono yana tasiri sosai ta manufar biyan kuɗi
Anonim

Abin da Medicare zai biya da kuma inda masanin ilimin likitancin radiation ya yi abubuwa biyu ne da suka yi tasiri mai karfi da zabi na maganin radiation mai tsanani (IMRT) don magance ciwon nono, bisa ga labarin da aka buga Afrilu 29 a kan layi a cikin Journal of the National Cancer Institute. Amfani da IMRT da farashin maganin radiation ya karu sosai a tsawon lokacin binciken.

IMRT wata dabara ce ta isar da hasken wuta wacce ke daidaita igiyoyin radiation don dacewa da sifar ƙari ko gadon ƙari a yunƙurin ƙara girman adadin radiation zuwa ƙari yayin da ake rage adadin zuwa kyallen da ke kusa. Idan aka kwatanta da na al'ada, biyu- ko uku-girma radiation far, IMRT na iya rage m fata toxicity da kuma inganta kwaskwarima sakamakon ga matan da ke jurewa maganin kiyaye nono.

Amma akwai hanyoyin da suka fi sauƙi ga jiyya mai girma uku waɗanda zasu iya ba da fa'idodi iri ɗaya a ƙananan farashi. Don haka yana da rigima ko irin waɗannan jiyya sun tabbatar da biyan kuɗi na Medicare don IMRT.

Don duba na asibiti, alƙaluma, da sauran abubuwan da ke da alaƙa da lissafin kuɗi don IMRT a cikin masu cin gajiyar Medicare tare da ciwon nono, Benjamin D. Smith, MD, na Cibiyar Ciwon daji na MD Anderson a Houston, Texas, da abokan aiki sun yi amfani da bayanan Medicare ga mata 26, 163. tare da ciwon daji na nono wanda aka yi wa tiyata da maganin radiation daga 2001 zuwa 2005.

Sun gano cewa lissafin Medicare na IMRT ya karu fiye da sau 10 (ƙara daga 0.9% zuwa 11.2% na marasa lafiya da aka gano) a wannan lokacin. Matsakaicin farashin radiation a cikin shekarar farko na ganewar asali shine $ 7, 179 ba tare da IMRT ba da $15, 230 tare da IMRT.

A yankuna na ƙasar da masu ɗaukar Medicare na gida suka rufe IMRT, lissafin wannan magani ya fi sau biyar fiye da na yankunan da ba a rufe shi ba. Bugu da ƙari, lissafin kuɗi na IMRT ya kasance akai-akai ga marasa lafiya da likitocin ciwon daji ke bi da su a cikin cibiyoyin radiation masu zaman kansu (7.6% suna da IMRT) idan aka kwatanta da waɗanda aka yi musu magani a asibitocin asibiti (5.4% suna da IMRT).

A cikin tattaunawar da suka yi, marubutan sun lura cewa, akwai hanyoyi guda biyu don cimma matsananciyar gyare-gyare na katakon radiyo, daya da ake kira shirin gaba-da-filin da kuma wanda ake kira inverse planning. Na biyu ya fi tsada, yana buƙatar ƙarin likita da lokacin tsara magani. Yawancin dillalai na Medicare suna buƙatar tsarin da bai dace ba don mayar da kuɗin IMRT, kodayake hanyoyin biyu suna iya samun sakamako iri ɗaya don maganin nono kawai, a cewar marubutan.

Sun rubuta cewa bayanan su "suna ba da shawarar cewa game da maganin radiation na nono, yawancin bambance-bambancen farashi za a iya danganta su kai tsaye zuwa ma'anar jiyya marasa daidaituwa da kuma biyan kuɗin da Medicare da masu shiga tsakani suka ba da izini."

A cikin edita mai rahusa, Lisa A. Kachnic, MD, na Makarantar Magunguna ta Jami'ar Boston, da Simon N. Powell, MD, Ph.D., na Memorial Sloan-Kettering Cancer Center, New York, lura cewa shaidar da ke goyan bayan tsarin yau da kullum. yin amfani da IMRT da aka saba shiryawa ga marasa lafiya da ke buƙatar nono kawai magani yana da rauni. Suna ba da shawarar cewa ƙimar gaskiya na IMRT da aka yi niyya za ta kasance ga marasa lafiya masu rikitarwa masu rikitarwa ko waɗanda ke da ci gaban kansar nono waɗanda ke buƙatar cikakkiyar maganin kumburin lymph kamar radiation zuwa sarkar nodal na mammary na ciki. IMRT na iya taimakawa wajen kare huhu da zuciya, in ji su. Duk da haka ana buƙatar manyan gwaje-gwaje na bazuwar don tantance ko ainihin yana da waɗannan fa'idodin.

A halin yanzu, masu edita sun rubuta, wannan binciken "ya bayyana don tabbatar da zargin mutane da yawa, a ciki da wajen masana'antar kiwon lafiya, cewa yanke shawara na likita yana da tasiri sosai ta hanyar biyan kuɗi maimakon larura na likita."

Shahararren taken