BackgroundSCCHN is the sixth most common cancer worldwide. Locally advanced SCCHN continues to be a therapeutic challenge with high rates of morbidity and mortality and a low cure rate. Despite the apparent impact of SCCHN on patients and presumably society, the economic burden of the treatment of resected SCCHN patients in the UK has not been investigated.MethodsThis retrospective data analysis was based on in- and outpatient care records extracted from Hospital Episode Statistic database and linked to mortality data in the UK. SCCHN patients with resection of lip, tongue, oral cavity, pharynx or larynx were followed for at least one year (max. of 5 years) from the date of first resection.ResultsA total of 11,403 patients (mean age 63.2 years, 69.8% males) who met study criteria were followed for an average of 31 months. 32.3% of patients died in the follow-up period and the mean time to death was 16.9 months. In the first year, mean number of days of hospitalization and number of outpatient visits was 21.6 and 4.2, respectively; mean number of reconstructive and secondary surgeries was 0.32 and 0.14 per patient, respectively; 4.7% of the patients received radiotherapy and 12.2% received chemotherapy. From the second to fifth year healthcare utilizations rates were lower. Mean cost of post-operative healthcare utilization was £23,212 over 5 years (£19,778 for the first year and £1477, £847, £653 and £455 for years 2-5). Total cost of post-operative healthcare utilisation was estimated to be £255.5 million over the 5-year follow-up.ConclusionsIn the UK, SCCHN patients after surgical resection needed considerable healthcare resources and incurred substantial costs. Study findings might provide a useful source for clinicians and decision makers in understanding the economic burden of managing SCCHN in the UK and also suggests a need for new therapies that could improve outcomes and reduce the disease burden.
Objective: There are limited contemporary epidemiological data on the prevalence of carotid atherosclerosis in the general population. The aim was to determine the prevalence of and risk factors associated with carotid artery atherosclerosis among 65-year-old men. Methods: This was a population-based screening study. All 65-yearold men in the County of Uppsala, Sweden, who attended screening for abdominal aortic aneurysm (AAA) 2007e2009, were invited for duplex scanning of the carotid arteries. Results: Of 4801 men invited, 4657 (97%) accepted. Carotid plaques (>2 Â 6 mm) were observed in 1169 (25%) men, 94 (2.0%) had carotid stenoses (50e99%), and 15 (0.3%) had occluded carotid arteries. In a multivariate logistic regression model, smoking (OR 1.7, 95% CI 1.5e1.9), hypertension (1.5, 95% CI 1.3e1.7), diabetes mellitus (1.2, 95% CI 1.0e1.5), and coronary artery disease (1.5, 95% CI 1.3e1.8) were associated with prevalence of carotid atherosclerosis (plaque and/or stenosis). The use of antiplatelet agents and statins in participants with a carotid plaque was 20% and 29%, respectively. The corresponding figures in participants with a stenosis were 42% and 41%. Conclusions: This study offers contemporary data on the prevalence of carotid atherosclerosis in a population-based cohort of 65-year-old men. Most of those at risk had no other clinical manifestation of atherosclerosis, and therefore had no secondary prevention.
using an algorithm utilizing enrolment records and ICD-9 codes. A patient flow algorithm was constructed to define treatment cohorts. Patients were stratified based on the lung cancer drug treatment received following diagnosis and first line therapy. Total costs are report for the 1 year follow up period after initiation of drug treatment. RESULTS: A total of 2739 lung cancer patients were included in the analysis; 53% Ͼ65 yr. Paclitaxel or docetaxel plus platinum were the most commonly utilized 1st line regimens. Pemetrexed plus docetaxel was the most common 2nd line treatment. Among patients receiving 1st line treatment and remaining enrolled in the health plan, only 16.7% received 2nd line treatment. Total costs (average ϩ/Ϫ SD) in the year following chemotherapy initiation was $70,205 Ϯ 66,956
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