Effects of financial support on treatment of adolescents with growth hormone deficiency: a retrospective study in Japan.
BMC Health Serv Res
; 16(1): 602, 2016 10 21.
Article
de En
| MEDLINE
| ID: mdl-27769307
ABSTRACT
BACKGROUND:
Treatment costs for children with growth hormone (GH) deficiency are subsidized by the government in Japan if the children meet clinical criteria, including height limits (boys 156.4 cm; girls 145.4 cm). However, several funding programs, such as a subsidy provided by local governments, can be used by those who exceed the height limits. In this study, we explored the impacts of financial support on GH treatment using this natural allocation.METHODS:
A retrospective analysis of 696 adolescent patients (451 boys and 245 girls) who reached the height limits was conducted. Associations between financial support and continuing treatment were assessed using multiple logistic regression analyses adjusting for age, sex, height, growth velocity, bone age, and adverse effects.RESULTS:
Of the 696 children in the analysis, 108 (15.5 %) were still eligible for financial support. The proportion of children who continued GH treatment was higher among those who were eligible for support than among those who were not (75.9 % vs. 52.0 %, P < 0.001). The odds ratios of financial support to continuing treatment were 4.04 (95 % confidence interval [CI] 1.86-8.78) in boys and 1.72 (95 % CI 0.80-3.70) in girls, after adjusting for demographic characteristics and clinical factors.CONCLUSIONS:
Financial support affected decisions on treatment continuation for children with GH deficiency. Geographic variations in eligibility for financial support pose an ethical problem that needs policy attention. An appropriate balance between public spending on continuation of therapy and improved quality of life derived from it should be explored.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Soutien financier
/
Hormone de croissance humaine
/
Troubles de la croissance
Type d'étude:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Ethics
/
Patient_preference
Limites:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
Asia
Langue:
En
Journal:
BMC Health Serv Res
Sujet du journal:
PESQUISA EM SERVICOS DE SAUDE
Année:
2016
Type de document:
Article
Pays d'affiliation:
Japon