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. 2020 Jul 2;17(13):4765.
doi: 10.3390/ijerph17134765.

Assessment of Cancer Care Costs in Disease-Specific Cancer Care Pathways

Mattia Altini  1 , Laura Solinas  2 , Lauro Bucchi  3 , Nicola Gentili  4 , Davide Gallegati  2 , William Balzi  1 , Fabio Falcini  3   5 , Ilaria Massa  6
Affiliations

Assessment of Cancer Care Costs in Disease-Specific Cancer Care Pathways

Mattia Altini et al. Int J Environ Res Public Health. .

Abstract

In view of an efficient use of the Italian National Health Service-funded healthcare resources, a novel data-processing strategy combining information from multiple sources was developed in a regional cancer network of northern Italy. The goal was to calculate the annual overall cost of care pathways of six disease groups in 10,486 patients. The evaluation was conceived as a population-based cost description from the perspective of the Italian National Health Service. Costs occurred during a defined time period for a cross-section of patients at varying stages of their disease were measured. The total cancer care cost was €81,170,121 (11.1% of total local health expenditure), with a cost per patient of €7741.17 and a cost per capita of €204.62. Surgical, inpatient and day-hospital medical admissions, radiotherapy, drugs, outpatient care, emergency admissions, and home and hospice care accounted for 21.2%, 24.1%, 6.2%, 28.2%, 14.0%, 0.9%, and 5.4% of the total cost, respectively. The highest cost items included drugs (cost per capita, €22.95; 11.2% of total cost) and medical admissions (€14.51; 7.1%) for blood cancer, and surgical (€14.56; 7.1%) and medical admissions (€13.60; 6.6%) for gastrointestinal cancer. The information extracted allows multidisciplinary cancer care teams to be more aware of the costs of their clinical decisions.

Keywords: administrative data; cancer care cost; care pathway; healthcare cost.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1
Figure 1
Schematic diagram of the extract/transform/load (ETL) process for acquiring cross-sectional information from multiple sources. Except for the Hospice Database, the data sources are indicated with the standard abbreviation in Italian: ASA indicates Outpatient Specialist Assistance Database; EHR indicates Electronic Health Record, that is, the electronic clinical data record archive at the Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) of Meldola; SDO indicates Hospital Discharge Database; FED indicates Drugs Database; PS indicates Emergency Database; ADI indicates Home Care Database; REM indicates Mortality Registry.
Figure 2
Figure 2
Annual cancer cost per capita in euros incurred for each cost item and each disease group, sorted in descending order. The horizontal bar represents the corresponding percentage of total annual cancer cost (use percent values in the upper horizontal axis as a reference) (Province of Forlì-Cesena, northern Italy, year 2016).
See this image and copyright information in PMC

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