Hospital costs incurred by the Italian National Health Service for invasive cervical cancer

Abstract

Methods: A longitudinal, retrospective, cohort study was designed to assess the mean treatment cost of invasive cervical cancer, cross-linking clinical and administrative databases. The study was performed from the Italian NHS perspective. Costs were estimated using DRG charges. All patients with histological diagnosis of invasive cervical cancer admitted to Gynecologic Oncology centres of the Catholic University of the Sacred Heart between 2000 and 2007 were enrolled.

Results: Overall, 351 patients (212 with LACC and 139 with ECC) were eligible for analysis. The mean direct medical cost by patient was € 22,200 ± 21,600 with a significantly higher burden for LACC compared with ECC patients (€ 28,696 ± 24,874 versus € 12,329 ± 8,726). Radical surgery accounted for € 6,851 ± 1,406, and € 7,709 ± 3,710 in ECC and LACC group, respectively; the resulting difference achieved a statistical significance. The extent of disease, disease progression/recurrence, and length of hospitalization confirmed their independent role as cost predictive factors.

Conclusions: The combined use of administrative and clinical databases allowed a feasible assessment of the mean cost induced by the invasive cervical cancer. Management of LACC patients was associated with higher costs due to the utilization of several therapeutic strategies and more frequent appearance of disease progression/recurrence.