Comparing Cancer Care, Outcomes, and Costs Across Health Systems: Charting the Course

Lipscomb, Joseph; Yabroff, K. Robin; Hornbrook, Mark C.; Gigli, Anna; Francisci, Silvia; Krahn, Murray; Gatta, Gemma; Trama, Annalisa; Ritzwoller, Debra P.; Durand‐Zaleski, Isabelle; Salloum, Ramzi G.; Chawla, Neetu; Angiolini, Catia; Crocetti, Emanuele; Giusti, Francesco; Guzzinati, Stefano; Mezzetti, Maura; Miccinesi, Guido; Mariotto, Angela B.

doi:10.1093/jncimonographs/lgt011

Cited by 28 publications

(30 citation statements)

References 42 publications

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“…Undertaking cross-national or within-country costing studies can be challenging because administrative data, medical records and cancer registries were not designed for this type of research (Lipscomb et al 2013). Differences in the organization of healthcare systems (coverage policies, payment of physicians and submission of claims) can make cost comparisons quite complex (Lipscomb et al 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Differences in the organization of healthcare systems (coverage policies, payment of physicians and submission of claims) can make cost comparisons quite complex (Lipscomb et al 2013). Even within Canada, comparison of cancer-specific care, such as chemotherapy and RT, requires care because data are not recorded in a standard manner across provinces, and cost estimates are rarely available in the data.…”

Section: Discussionmentioning

confidence: 99%

“…Descriptive costing studies reflect the burden to healthcare systems and help translate the effects of health conditions into dollars. Furthermore, comparative studies between healthcare systems can inform evaluation, development or modification of policies and programs related to cancer screening, treatment and delivery of care (Lipscomb et al 2013). For example, a study comparing resource use for end-of-life care in patients with lung cancer in Ontario and Surveillance, Epidemiology and End Results (SEER) regions in the US found that hospital and emergency room services were used more extensively among Ontario patients, while chemotherapy use was significantly higher among SEER-Medicare patients (Warren et al 2011).…”

Section: Introductionmentioning

confidence: 99%

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Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Oliveira

Pataky

Bremner

et al. 2017

hcpol

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Results: Overall, costs were higher in Ontario. Costs were highest in the initial post-diagnosis and pre-death phases and lowest in the pre-diagnosis and continuing phases, and generally higher for brain cancer and multiple myeloma, and lower for melanoma. Hospitalization was the major cost category. Costs for physician services and diagnostic tests differed the most between provinces.Conclusions: The standardization of data and costing methodology is challenging, but it enables interprovincial and international comparative costing analyses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Oliveira

Pataky

Bremner

et al. 2017

hcpol

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“…Cancer care entails a substantial economic and societal burden . An increase in the overall cost of cancer care is anticipated due to a growing proportion of elderly individuals, improvements in treatment that extend survival, and integration of novel technologies .…”

Section: Introductionmentioning

confidence: 99%

Associations of specific postoperative complications with costs after radical cystectomy

et al. 2017

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ObjectiveTo quantify the financial impact of complications after radical cystectomy (RC) and their associations with respective 90-day costs, as RC is a morbid surgery plagued by complications and the expenditure attributed to specific complications after RC is not well characterised. Patients and MethodsWe used the Premier Hospital Database (Premier Inc., Charlotte, NC, USA) to identify 9 137 RC patients (weighted population of 57 553) from 360 hospitals between 2003 and 2013. Complications were categorised according to Agency for Healthcare Research and Quality Clinical Classifications. Patients with and without complications were compared, and multivariable analysis was performed. ResultsAn index complication increased costs by $9 262 (95% confidence interval [CI] 8 300-10 223) and a readmission complication increased costs by $20 697 (95% CI 18 735-22 660). The four most costly index complications (descending order) were venous thromboembolism (VTE), infection, wound and soft tissue complications, and pulmonary complications (P < 0.001, vs no complication). A complication increased length of stay by 4 days (95% CI 3.6-4.3). One in five patients were readmitted in 90 days and the four costliest readmission complications (descending order) were pulmonary, bleeding, VTE, and gastrointestinal complications (P < 0.001, vs no complication). Readmitted patients had multiple complications upon readmission (median of 3, interquartile range 2-4). On multivariable analysis, more comorbidities, longer surgery (>6 h), transfusions of >3 units, and teaching hospitals were associated with higher costs (P < 0.05), whilst high-volume surgeons and shorter surgeries (<4 h) were associated with lower costs (P < 0.05). ConclusionsComplications after RC increase index and readmission costs for hospitals, and can be categorised based on magnitude. Future initiatives in RC may also consider costs of complications when establishing quality improvement priorities for patients, providers, or policymakers.

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“…3,4 Health administrative data provide opportunities to examine the patterns and costs of end-of-life care in large populations of patients 5-10 and across countries. 11,12 Canada and the United States share geographic proximity but differ substantially in the funding, administration, and delivery of health care. [13][14][15] In Canada, universal health-care insurance plans are managed by provincial and territorial governments and provide coverage for all permanent residents.…”

Section: Introductionmentioning

confidence: 99%

An international comparison of costs of end-of-life care for advanced lung cancer patients using health administrative data

et al. 2015

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Comparing Cancer Care, Outcomes, and Costs Across Health Systems: Charting the Course

Cited by 28 publications

References 42 publications

Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Estimating the Cost of Cancer Care in British Columbia and Ontario: A Canadian Inter-Provincial Comparison

Associations of specific postoperative complications with costs after radical cystectomy

An international comparison of costs of end-of-life care for advanced lung cancer patients using health administrative data

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