Quality Of Life Of Early Breast Cancer Patients And Medical Cost Analysis

Objective: To evaluate the quality of life for early breast cancer patients in Shenzhen and Wuhan who have lived more than one year after operation, and to explore the influencing factors on the quality of life. According to the result, we can make intervention correctly. By analyzing the medical cost in Shenzhen and Wuhan, we can offer some reference for making health policy and reforming medical insurance system. The economic burden of the cancer patients will be lessened, and the quality of life after operation will be improved. To estimate the reliability and validity of the Chinese version of the FACT-B scale.Methods: To measure the Quality of life by self-report and their confidants-report by the FACT-B. Then, find the influencing factors by analyzing the data with multiple linear regression analysis. To analyze the medical cost by statistical methods, such as ANOVA or rank sum test. To assess reliability and validity of the FACT-B scale by factor analysis and correlation analysis.Results: The quality of life for patients in Wuhan and Shenzhen was not very satisfied, and needs to be improved. The influencing factors in Shenzhen included education, physical exercise after surgery, clinical stage, age, and so on. The influencing factors in Wuhan included physical exercise before developing breast cancer, present marriage status, present job, the payment manner of medical expenses, recurrence or metastasis after operation, and so on.In Shenzhen, the cost of surgery was almost made up of the expense of medicine and examination. The cost of chemotherapy was almost made up of the expense of medicine. And the actinotherapy cost was almost made up of the expense of radiation. The surgery cost in 2003 and 2004 was more than the cost in last two years, p=0.0021. There was no statistical significance among the costs of chemotherapy from 2001 to 2004, but the medicine cost among them had statistical significance, p=0.0026. There was no statistical significance among the cost of actinotherapy from 2001 to 2004, neither did the radiation costs. There was statistical significance among different treatment methods, p=0.0008. There was statistical significance among all costs from 2001 to 2004, p<0.05. So did the whole medicine costs and the whole treatment costs. In Wuhan, the expense of surgery was almost made up of the expense of medicine. There was statistical significance among all cost of surgery from 2001 to 2003, so did medicine costs, examination cost and treatment cost, p<0.01. There was statistical significance among the expenses of different operation ways, p<0.0001.The comparison of quality of life between Shenzhen and Wuhan showed that patients in Shenzhen got lower scores of emotional well being, p=0.0021. The comparison of medical cost of improved radical correction between Shenzhen and Wuhan showed that there was statistical significance among medicine costs from 2001 to 2003. So did examination costs. And the statistical significance among other costs depends on different years.The Cronbach's alpha coefficient and split-half reliability coefficient of the Chinese version of the FACT-B was 0.76 and 0.87. 10 common factors were extracted and the cumulative variance was 79.67%. 5 aspects can be merged from the 10 common factors, and the 5 aspects were essentially consistent with the 5 domains of the FACT-B. The coefficients between every domain and the scale were larger than the coefficients between every domain and others.Conclusion: The reasonable valid intervention can be offered according to the influencing factors on the quality of life for early breast cancer patients in Shenzhen and Wuhan who have lived more than one year after operation. There was no statistical significance between self-report and confidant-report. Whether the quality of life for breast cancer patients can be estimated by confidant-report, the further study should be developed. The tendency of the medical cost of early breast cancer was increasing. So it was important to decrease the price of medicine and examination, to avoid excess treatment, to expand the range of Medicare, to improve a multiform healthy care system, to reduce the economic burden of poor patients. And it was the focus of health work in Wuhan and Shenzhen at present. The Chinese version of the FACT-B had good reliability and validity and can be used to assess the quality of life for Chinese breast cancer patients. But some items in additional concerns domain were needed to revise and test to adapt the Chinese culture.