Using sound Clinical Paths and Diagnosis-related Groups (DRGs)-based payment reform to bring benefits to patient care: A case study of leukemia therapy

Zhang, Zhi-Ruo; Mi, Jian-Qing; Gu, Long-Jun; Tang, Jingyan; Shen, Shuhong; Wen, Zhao-Jun; Chen, Sai‐Juan; Chen, Zhu

doi:10.1007/s11684-010-0018-5

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…In December 2004, a standardized, cost-efficient protocol was developed jointly by the Shanghai Children’s Medical Center, the Beijing Children’s Hospital, and St. Jude Children’s Research Hospital to treat underprivileged children with low- and intermediate-risk ALL with the support of a charitable foundation. In 2009, the effectiveness and the affordability (&14,000 USD) of the clinical trial were reported 138 , which prompted the Ministry of Health in 2010 to provide governmental funding toward the treatment of children with ALL 145 . With this drastic increase in the number of patients having access to treatment and the unprecedented opportunity of clinical and translational research, Shanghai Children’s Medical Center and St. Jude Children’s Research Hospital in October 2014 formed a national childhood ALL study group comprising 20 major hospitals and medical centers across China.…”

Section: Global Impact Of Childhood Allmentioning

confidence: 99%

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Pui

Yang

Bhakta

et al. 2018

The Lancet Child & Adolescent Health

100

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Improvements in risk-directed treatment and supportive care, together with increased reliance on both national and international collaborative studies, have made childhood acute lymphoblastic leukaemia (ALL) one of the most curable human cancers. Next-generation sequencing studies of leukaemia cells and the host germline provide new opportunities for precision medicine and thus potential improvements in the cure rate and quality of life of patients. Efforts are underway to assess the global impact of childhood ALL and develop initiatives that can meet the long-term challenge of providing quality care to children with this disease worldwide and improving cure rates globally. This ambitious task will rely on increased collaborative research and international networking so that the therapeutic gains in high-income countries can be translated to patients in low-income and middle-income countries. Ultimately, the greatest obstacle to overcome will be to fully understand leukaemogenesis, enabling measures to decrease the risk of leukaemia development and thus close the last major gap in offering a cure to any child who might have the disease.

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Section: Global Impact Of Childhood Allmentioning

confidence: 99%

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Pui

Yang

Bhakta

et al. 2018

The Lancet Child & Adolescent Health

100

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“…This report caught the attention of Chinese government officials. 28 In 2011, the Health Minister of China added the treatment of low-or intermediate-risk ALL to the national health insurance coverage, reimbursing hospitals for 75% of expenses. This action immediately increased the number of children with access to care and reduced the rate of abandonment.…”

Section: Pediatric Hematology/oncology Units In Shanghai and Beijingmentioning

confidence: 99%

Global Pediatric Oncology: Lessons From Partnerships Between High-Income Countries and Low- to Mid-Income Countries

Ribeiro

Antillón

Pedrosa

et al. 2016

JCO

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Partnerships between medical institutions in high-income countries (HICs) and low-to mid-income countries (LMICs) have succeeded in initiating and expanding pediatric cancer control efforts. The long-term goal is consistently a sustainable national pediatric cancer program. Here, we review the elements required for successful implementation, development, and long-term sustainability of pediatric cancer programs in LMICs that first arise as partnerships with institutions in HICs. Although plans must be adapted to each country's resources, certain components are unfailingly necessary. First, an essential step is provision of treatment regardless of ability to pay. Second, financial support for program development and long-term sustainability must be sought from sources both international and local, public and private. A local leader, typically a well-trained pediatric oncologist who devotes full-time effort to the project, should direct medical care and collaborate with hospital, governmental, and community leadership and international agencies. Third, nurses must be trained in pediatric cancer care and allowed to practice this specialty full-time. It is also essential to develop a grassroots organization, such as a foundation, dedicated solely to pediatric oncology. Its members must be trained and educated to provide pediatric cancer advocacy, fundraising, and (in concert with government) program sustainability. Finally, a project mentor in the HIC is crucial and should explore the possibility of collaborative research in the LMIC, which may offer significant opportunities. Relationships between the partnership's leaders and influential individuals in the community, hospital, grassroots foundation, and government will lay the foundation for productive collaboration and a sustainable pediatric oncology program.

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“…In 2010, childhood ALL was selected as 1 of the 3 highly curable diseases to test this new insurance plan. 4 In the first year of this program, treatment access was provided to more than 7000 children with lowrisk or intermediate-risk ALL, attesting to the immense influence of this initiative. This health insurance has now been extended to all children with ALL, as well as to those with other catastrophic diseases.…”

mentioning

confidence: 99%

“…This community-based health insurance would increase health care access for low-income individuals with catastrophic diseases and covered most of the treatment expenses for 95% of the entire rural population. In 2010, childhood ALL was selected as 1 of the 3 highly curable diseases to test this new insurance plan . In the first year of this program, treatment access was provided to more than 7000 children with low-risk or intermediate-risk ALL, attesting to the immense influence of this initiative.…”

mentioning

confidence: 99%

The International Collaboration to Save Children With Cancer

Tang

Pui

2021

JAMA Oncol

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Cure of childhood cancer has become a realistic goal in high-income countries with state-of-the-art medical resources. Sadly, cure rates remain low in low-income countries, where only a small fraction of children have access to cancer therapy. What, then, can be accomplished to address this gap in medical progress? We suggest a multilayered strategy, involving 1 or more cancer centers, philanthropists, charitable organizations, and government agencies, that would transcend medical issues to address some of the socioeconomic hardships faced by countries with limited resources. This approach is well exemplified by the collaborative programs established between medical centers and hospitals in China and St Jude Children's Research Hospital since 1991, and, in our view, could provide a useful blueprint for saving the lives of thousands of children every year.After learning in 2003 that most children in China with acute lymphoblastic leukemia (ALL) abandoned treatment mainly for financial reasons and that only 30% of the patients in the rural areas were treated with curative intent, 1,2 St Jude expanded its effort to respond to these disparities. Thus, investigators from Shanghai Children's Medical Center (SCMC), Beijing Children's Hospital, and St Jude Children's Research Hospital devised an efficacious and cost-effective treatment protocol to enroll underprivileged children with low-risk or intermediate-risk ALL who could not afford treatment. The entire cost of therapy was met by the Partner in Hope Foundation (Hong Kong), established by a member of the St Jude's Board of Governors. Three years into this protocol, several supportive-care initiatives were added, including infection control, palliative care, nursing education, and housing for patients' families during remission induction. Of the 155 patients treated, 131 (84.5%) remain alive in remission.The excellent outcome and cost-effectiveness (<$11 000 per patient) of this protocol reported in 2009 3 drew the attention of the Ministry of Health of the People's Republic of China, which was developing an ambitious health care reform: the New Rural Cooperative Medical Scheme. This community-based health insurance would increase health care access for low-income individuals with catastrophic diseases and covered most of the treatment expenses for 95% of the entire rural population. In 2010, childhood ALL was selected as 1 of the 3 highly curable diseases to test this new insurance plan. 4 In the first year of this program, treatment access was provided to more than 7000 children with lowrisk or intermediate-risk ALL, attesting to the immense influence of this initiative. This health insurance has now been extended to all children with ALL, as well as to those with other catastrophic diseases.

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Using sound Clinical Paths and Diagnosis-related Groups (DRGs)-based payment reform to bring benefits to patient care: A case study of leukemia therapy

Cited by 8 publications

References 15 publications

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Global efforts toward the cure of childhood acute lymphoblastic leukaemia

Global Pediatric Oncology: Lessons From Partnerships Between High-Income Countries and Low- to Mid-Income Countries

The International Collaboration to Save Children With Cancer

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