Lindsay Daniel, Bates Nicole, Diaz Abbey, Watt Kerrianne, Callander Emily
School of Public Health, The University of Queensland, Brisbane, Australia.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
Support Care Cancer. 2022 Mar;30(3):2141-2150. doi: 10.1007/s00520-021-06570-6. Epub 2021 Oct 22.
With increasing rates of cancer survival due to advances in screening and treatment options, the costs of breast cancer diagnoses are attracting interest. However, limited research has explored the costs to the Australian healthcare system associated with breast cancer. We aimed to describe the cost to hospital funders for hospital episodes and emergency department (ED) presentations for Queensland women with breast cancer, and whether costs varied by demographic characteristics.
We used a linked administrative dataset, CancerCostMod, limited to all breast cancer diagnoses aged 18 years or over in Queensland between July 2011 and June 2015 (n = 13,285). Each record was linked to Queensland Health Admitted Patient Data Collection and Emergency Department Information Systems records between July 2011 and June 2018. The cost of hospital episodes and ED presentations were determined, with mean costs per patient modelled using generalised linear models with a gamma distribution and log link function.
The total cost to the Queensland healthcare system from hospital episodes for female breast cancer was AUD$309 million and AUD$12.6 million for ED presentations during the first 3 years following diagnosis. High levels of costs and service use were identified in the first 6 months following diagnosis. Some significant differences in cost of hospital and ED episodes were identified based on demographic characteristics, with Indigenous women and those from lower socioeconomic backgrounds having higher costs.
Hospitalisation costs for breast cancer in Queensland exert a high burden on the healthcare system. Costs are higher for women during the first 6 months from diagnosis and for Indigenous women, as well as those with underlying comorbidities and lower socioeconomic position.
随着筛查和治疗手段的进步，癌症生存率不断提高，乳腺癌诊断成本备受关注。然而，针对澳大利亚医疗系统中与乳腺癌相关成本的研究有限。我们旨在描述昆士兰乳腺癌女性患者住院治疗和急诊科就诊给医院资助方带来的成本，以及成本是否因人口统计学特征而异。
我们使用了一个关联管理数据集CancerCostMod，该数据集仅限于2011年7月至2015年6月昆士兰年龄在18岁及以上的所有乳腺癌诊断病例（n = 13285）。每条记录与2011年7月至2018年6月昆士兰卫生部门的住院患者数据收集和急诊科信息系统记录相关联。确定了住院治疗和急诊科就诊的成本，并使用具有伽马分布和对数链接函数的广义线性模型对每位患者的平均成本进行建模。
女性乳腺癌患者住院治疗给昆士兰医疗系统带来的总成本为3.09亿澳元，诊断后的前3年急诊科就诊成本为1260万澳元。诊断后的前6个月成本和服务使用水平较高。根据人口统计学特征确定了住院和急诊科就诊成本的一些显著差异，原住民女性以及社会经济背景较低的女性成本较高。
昆士兰乳腺癌的住院成本给医疗系统带来了沉重负担。诊断后的前6个月女性、原住民女性以及患有基础合并症和社会经济地位较低的女性成本更高。
