Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland

Abstract

The cost-effectiveness of novel interventions in the treatment of cancer is well researched; however, relatively little attention is paid to the cost of many aspects of routine care. Oesophageal cancer is the ninth most common cancer in the UK and sixth most common cause of cancer death. It usually presents late and has a poor prognosis. The hospital costs incurred by oesophageal cancer patients diagnosed in Northern Ireland in 2005 (n = 198) were determined by review of medical records. The average cost of hospital care per patient in the 12 months from presentation was £7847. Variations in total hospital costs by age at diagnosis, gender, cancer stage, histological type, mortality at 1 year, co-morbidity count and socio-economic status were analysed using multiple regression analyses. Higher costs were associated with earlier stages of cancer and cancer stage remained a significant predictor of costs after controlling for cancer type, patient age and mortality at 1 year. Thus, although early detection of cancer usually improves survival, this would mean increased costs in the first year. Deprivation achieved borderline significance with those from more deprived areas having lower resource consumption relative to the more affluent.

Medical expenditure for esophageal cancer in China: a 10-year multicenter retrospective survey (2002–2011)

“…We found that more than 90% of the expenses occurred within 12 months, which was higher than China’s GDP per capita (36,018 CNY in 2011) [ 10 ]. As a comparison, the newly diagnosed medical expenditure was less than 40% of the GDP per capita (2005) in the United Kingdom [ 11 ], less than 60% (2008–2010) in the United States [ 12 ], and less than 65% (1997–2007) in Canada [ 13 ]. According to data from China on the average family population (2.9) and the per capita disposable income (21,810 CNY) of urban households in 2011 [ 10 ], we found that the average medical expenditure per patient for esophageal cancer was 72.9% of the average family annual income for urban households, indicating that the economic burden imposed by esophageal cancer was relatively high for individual patients’ families in China, especially for low-income families.…”

Mortality and cost of radiation therapy for oesophageal cancer according to hospital accreditation level: a nationwide population-based study

“…The average cost of treating oesophageal cancer is increasing annually (Ho et al 2013). Although we believed early stage of cancer is a significant indicator of better outcome, higher hospital costs were associated with earlier stage of oesophageal cancer in Northern Ireland (Agus et al 2013). To clarify the influence of radiotherapy, we excluded the surgery code in this study.…”

Annual cost of illness of stomach and esophageal cancer patients in urban and rural areas in China: A multi-center study

“…Guo et al ( 4 ) reported that for esophageal cancer, stage II patients had the highest medical expenditure during 2009−2011 in urban China. In terms of hospitalization cost per patient that covered the first year after diagnosis, stage II was the most expensive for esophageal cancer patients in Northern Ireland as well ( 7 ) whereas in Korea, advanced stages at diagnosis were associated with 1.8−2.5 folds higher costs ( 10 ). Compared with patients in US, Chinese stomach cancer patients had larger tumors and later stages ( 32 ), which were generally associated with shorter survival ( 33 ).…”

“…Moreover, these studies were carried out in either one area (county, province) ( 5 , 6 ) or only urban areas ( 4 ). To date, in-depth studies on the cost of illness of stomach or esophageal cancer at patient level have been conducted mainly in developed countries ( 7 - 12 ). In the patients who survived beyond 1 year in Ontario, esophageal cancer was the costliest cancer while stomach cancer was the fifth costliest ( 9 ).…”

“…In the patients who survived beyond 1 year in Ontario, esophageal cancer was the costliest cancer while stomach cancer was the fifth costliest ( 9 ). Australian and British researchers unveiled that surgery and stage I were associated with higher hospitalization costs of esophageal cancer ( 7 , 8 ), whereas a Korean study showed that advanced stages were associated with higher total costs ( 10 ). Furthermore, age was found to be positively associated with the hospitalization cost of stomach cancer by Japanese researchers ( 11 ).…”