Romina Rossi1, Valentina Danesi2, Ilaria Massa3, William Balzi2, Antonino Romeo4, Flavia Foca5, Oriana Nanni5, Marco Maltoni1, Mattia Altini2. 1. Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola, FC, 47014, Italy. 2. Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, Meldola, FC, 47014, Italy. 3. Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, Meldola, FC, 47014, Italy. ilaria.massa@irst.emr.it. 4. Radiotherapy Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola, FC, 47014, Italy. 5. Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola, FC, 47014, Italy.
Abstract
PURPOSE: Cost evaluation is becoming mandatory to support healthcare sustainability and optimize the decision-making process. This topic is a challenge, especially for complex and rapidly evolving treatment modalities such as radiotherapy (RT). The aim of the present study was to investigate the cost of RT in the last month of life of patients in an Italian cancer center. METHODS: This was a retrospective study on a cancer population (N= 160) who underwent RT or only an RT planning simulation in an end of life (EOL) setting. The cost of RT procedures performed on patients was collected according to treatment status, care setting, and RT technique used. Costs were valued according to the sum of reimbursements relating to all procedures performed and assessed from the perspective of the National Health System. RESULTS: The total cost of RT in the last month of life was €244,774, with an average cost per patient of €1530. Around 7.7% and 30.3% of the total cost was associated with patients who never started RT or who discontinued RT, respectively, while the remaining 62.0% referred to patients who completed treatment. Costs associated with outpatient and inpatient settings represented 54.3% and 38.6% of the total cost, respectively. The higher average cost per patient for the never-started and discontinued groups was correlated with patients who had a poor ECOG Performance Status. CONCLUSION: Improved prognostic accuracy and a better integration between radiotherapy and palliative care units could be a key to a better use of resources and to a reduction in the cost of EOL RT.
PURPOSE: Cost evaluation is becoming mandatory to support healthcare sustainability and optimize the decision-making process. This topic is a challenge, especially for complex and rapidly evolving treatment modalities such as radiotherapy (RT). The aim of the present study was to investigate the cost of RT in the last month of life of patients in an Italian cancer center. METHODS: This was a retrospective study on a cancer population (N= 160) who underwent RT or only an RT planning simulation in an end of life (EOL) setting. The cost of RT procedures performed on patients was collected according to treatment status, care setting, and RT technique used. Costs were valued according to the sum of reimbursements relating to all procedures performed and assessed from the perspective of the National Health System. RESULTS: The total cost of RT in the last month of life was €244,774, with an average cost per patient of €1530. Around 7.7% and 30.3% of the total cost was associated with patients who never started RT or who discontinued RT, respectively, while the remaining 62.0% referred to patients who completed treatment. Costs associated with outpatient and inpatient settings represented 54.3% and 38.6% of the total cost, respectively. The higher average cost per patient for the never-started and discontinued groups was correlated with patients who had a poor ECOG Performance Status. CONCLUSION: Improved prognostic accuracy and a better integration between radiotherapy and palliative care units could be a key to a better use of resources and to a reduction in the cost of EOL RT.
Entities:
Keywords:
End of life; Healthcare costs; Healthcare sustainability; Radiotherapy
Authors: Craig C Earle; Elyse R Park; Bonnie Lai; Jane C Weeks; John Z Ayanian; Susan Block Journal: J Clin Oncol Date: 2003-03-15 Impact factor: 44.544
Authors: Jennifer S Temel; Joseph A Greer; Alona Muzikansky; Emily R Gallagher; Sonal Admane; Vicki A Jackson; Constance M Dahlin; Craig D Blinderman; Juliet Jacobsen; William F Pirl; J Andrew Billings; Thomas J Lynch Journal: N Engl J Med Date: 2010-08-19 Impact factor: 91.245
Authors: Florian Rudolf Schroeck; Bruce L Jacobs; Sam B Bhayani; Paul L Nguyen; David Penson; Jim Hu Journal: Eur Urol Date: 2017-03-31 Impact factor: 20.096
Authors: C A Perez; B Kobeissi; B D Smith; S Fox; P W Grigsby; J A Purdy; H D Procter; T H Wasserman Journal: Int J Radiat Oncol Biol Phys Date: 1993-04-02 Impact factor: 7.038
Authors: Nirav S Kapadia; Rizvan Mamet; Carrie Zornosa; Joyce C Niland; Thomas A D'Amico; James A Hayman Journal: Cancer Date: 2012-01-17 Impact factor: 6.860
Authors: Rohit K Singal; Robert Sibbald; Brenda Morgan; Mel Quinlan; Neil Parry; Michael Radford; Claudio M Martin Journal: Can Respir J Date: 2013-12-23 Impact factor: 2.409
Authors: Craig C Earle; Bridget A Neville; Mary Beth Landrum; John Z Ayanian; Susan D Block; Jane C Weeks Journal: J Clin Oncol Date: 2004-01-15 Impact factor: 44.544
Authors: M Barbieri; H L A Weatherly; R Ara; H Basarir; M Sculpher; R Adams; H Ahmed; C Coles; T Guerrero-Urbano; C Nutting; M Powell Journal: Appl Health Econ Health Policy Date: 2014-10 Impact factor: 2.561