Paulus Torkki1,2, Riikka-Leena Leskelä3, Miika Linna2, Suvi Mäklin4, Jukka-Pekka Mecklin5,6, Petri Bono7, Vesa Kataja5, Sakari Karjalainen4. 1. a Department of Public Health, Faculty of Medicine , University of Helsinki , Helsinki , Finland. 2. b Industrial Management and Engineering , Aalto-yliopisto Tuotantotalouden laitos , Aalto , Finland. 3. c Nordic Healthcare Group Ltd , Helsinki , Finland. 4. d Cancer Society of Finland , Helsinki , Finland. 5. e Surgical Department , Central Finland Central Hospital , Jyväskylä , Finland. 6. f Department of Sport and Health Science, University of Jyväskylä , Jyväskylä , Finland. 7. g Department of Oncology , Helsinki University Central Hospital , Helsinki , Finland.
Abstract
BACKGROUND: The cost of cancer and outcomes of cancer care have been discussed a lot since cancer represents 3-6% of total healthcare costs and cost estimations have indicated growing costs. There are studies considering the cost of all cancers, but studies focusing on the cost of disease and outcomes in most common cancer sites are limited. The objective of this study was to analyze the development of the costs and outcomes in Finland between 2009 and 2014 per cancer site. METHODS: The National cost, episode and outcomes data were obtained from the National register databases based on International Statistical Classification of Diseases (ICD)-10 diagnosis codes. Cost data included both the direct and indirect costs. Two hospitals were used to validate the costs of care. The outcome measures included relative survival rate, mortality, sick leave days per patient and number of new disability pensions. FINDINGS: The outcomes of cancer care in most common cancer sites have improved in Finland between 2009-2014. The real costs per new cancer patient decreased in seven out of ten most common cancer sites. The significance of different cost components differ significantly between the different cancer sites. The share of medication costs of the total cost of all cancers increased, but decreased for the five most common cancer sites. INTERPRETATION: The changes in the cost components indicate that the length of stay has shortened in special care and treatment methods have developed towards outpatient care. This partially explains the decrease of costs. Also, at the same time outcomes improved, which indicates that decrease in costs did not come at the expense of treatment quality. As the survival rates increase, the relevance of mortality measures decreases and the relevance of other, patient-relevant outcome measures increases. In the future, the outcomes and costs of health care systems should be assessed routinely for the most common patient groups.
BACKGROUND: The cost of cancer and outcomes of cancer care have been discussed a lot since cancer represents 3-6% of total healthcare costs and cost estimations have indicated growing costs. There are studies considering the cost of all cancers, but studies focusing on the cost of disease and outcomes in most common cancer sites are limited. The objective of this study was to analyze the development of the costs and outcomes in Finland between 2009 and 2014 per cancer site. METHODS: The National cost, episode and outcomes data were obtained from the National register databases based on International Statistical Classification of Diseases (ICD)-10 diagnosis codes. Cost data included both the direct and indirect costs. Two hospitals were used to validate the costs of care. The outcome measures included relative survival rate, mortality, sick leave days per patient and number of new disability pensions. FINDINGS: The outcomes of cancer care in most common cancer sites have improved in Finland between 2009-2014. The real costs per new cancerpatient decreased in seven out of ten most common cancer sites. The significance of different cost components differ significantly between the different cancer sites. The share of medication costs of the total cost of all cancers increased, but decreased for the five most common cancer sites. INTERPRETATION: The changes in the cost components indicate that the length of stay has shortened in special care and treatment methods have developed towards outpatient care. This partially explains the decrease of costs. Also, at the same time outcomes improved, which indicates that decrease in costs did not come at the expense of treatment quality. As the survival rates increase, the relevance of mortality measures decreases and the relevance of other, patient-relevant outcome measures increases. In the future, the outcomes and costs of health care systems should be assessed routinely for the most common patient groups.
Authors: Anna Gigli; Silvia Francisci; Giulia Capodaglio; Daniela Pierannunzio; Sandra Mallone; Andrea Tavilla; Tania Lopez; Manuel Zorzi; Fabrizio Stracci; Susanna Busco; Walter Mazzucco; Sara Lonardi; Fortunato Bianconi; Antonio Giampiero Russo; Silvia Iacovacci; Diego Serraino; Gianfranco Manneschi; Mario Fusco; Rosanna Cusimano; Massimo Rugge; Stefano Guzzinati Journal: Int J Environ Res Public Health Date: 2021-01-08 Impact factor: 3.390