School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada 2 Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada 3 Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada 4 Royal Ottawa Mental Health Center, Ottawa, ON K1Z 7K4, Canada.
Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
Curr Oncol. 2024 Jul 25;31(8):4192-4208. doi: 10.3390/curroncol31080313.
Hematologic cancers, notably leukemias and lymphomas, pose significant challenges to healthcare systems globally, due to rising incidence rates and increasing costs. This study aimed to estimate the phase and lifetime health system total costs (not net costs) of care for patients diagnosed with leukemia and lymphoma in Ontario, Canada. We conducted a population-based study of patients diagnosed between 2005 and 2019, using data from the Ontario Cancer Registry linked with health administrative databases. Costs were estimated using a phase-based approach and stratified by care phase and cancer subtype. Acute lymphocytic leukemia (ALL) patients had the highest mean monthly initial (CAD 19,519) and terminal (CAD 41,901) costs among all cancer subtypes, while acute myeloid leukemia (AML) patients had the highest mean monthly cost (CAD 7185) during the continuing phase. Overall lifetime costs were highest for ALL patients (CAD 778,795), followed by AML patients (CAD 478,516). Comparatively, patients diagnosed with Hodgkin lymphoma (CAD 268,184) and non-Hodgkin lymphoma (CAD 321,834) had lower lifetime costs. Major cost drivers included inpatient care, emergency department visits, same-day surgeries, ambulatory services, and specialized cancer drugs. Since 2005, the cost structure has evolved with rising proportions of interventional drug costs. Additionally, costs were higher among males and younger age groups. Understanding these costs can help guide initiatives to control healthcare spending and improve cancer care quality.
血液系统癌症，特别是白血病和淋巴瘤，由于发病率上升和成本增加，给全球医疗系统带来了重大挑战。本研究旨在估计加拿大安大略省诊断为白血病和淋巴瘤患者的护理阶段和终身健康系统总成本（非净成本）。我们对 2005 年至 2019 年间诊断出的患者进行了一项基于人群的研究，使用了安大略省癌症登记处与健康管理数据库链接的数据。成本使用基于阶段的方法进行估计，并按护理阶段和癌症亚型进行分层。在所有癌症亚型中，急性淋巴细胞白血病（ALL）患者的初始（CAD19519）和终末期（CAD41901）月平均费用最高，而急性髓细胞白血病（AML）患者在持续阶段的月平均费用最高（CAD7185）。总体终身成本以 ALL 患者最高（CAD778795），其次是 AML 患者（CAD478516）。相比之下，诊断为霍奇金淋巴瘤（CAD268184）和非霍奇金淋巴瘤（CAD321834）的患者的终身成本较低。主要成本驱动因素包括住院护理、急诊就诊、当日手术、门诊服务和专门的癌症药物。自 2005 年以来，随着介入性药物成本比例的上升，成本结构发生了变化。此外，男性和年龄较小的群体的成本更高。了解这些成本可以帮助指导控制医疗支出和提高癌症护理质量的举措。
