Jahan Shafkat, Lindsay Daniel, Diaz Abbey, Li Ming, Cunningham Joan, Garvey Gail
First Nations Cancer and Wellbeing Research Program, Faculty of Health, Medicine and Behavioural Sciences, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
Cancer Health Economics, Cancer Council Queensland, Brisbane, Queensland, Australia.
Cancer Med. 2025 Sep;14(17):e71193. doi: 10.1002/cam4.71193.
To quantify costs incurred by the health system for hospital episodes and emergency department (ED) presentations for pancreatic cancer patients within the first three years after diagnosis in Queensland, Australia.
Using a linked administrative dataset, CancerCostMod, which includes cancer diagnoses from the Queensland Cancer Registry (1st July 2011-30th June 2015) and linked Queensland Health Admitted Patient Data Collection and ED Information Systems records (1st July 2011-30th June 2018), we assessed costs for adults diagnosed with primary pancreatic cancer (International Classification of Diseases, 10th Revision: C25). Costs (in Australian dollars) were assigned using national public costs and private hospital charge datasets for the relevant year. Descriptive analyses were conducted to evaluate hospital and ED utilization and costs. Cost variations across sociodemographic and clinical characteristics were assessed using Kruskal-Wallis or Mann-Whitney U tests.
Among 2082 individuals diagnosed with pancreatic cancer, hospital episodes (n = 26,405) in the first three years after diagnosis cost a total of $100.7 million; median cost per patient was $36,832. For ED presentations (n = 4228), corresponding figures were $3.6 million (total) and $963 (median per patient). Most of the total hospital (81%) and ED (79%) costs occurred in the first year after diagnosis. Patients who survived ≤ 6 months had the lowest median cost per patient but accounted for 38% of total hospital costs. Median cost per patient varied substantially by socio-demographic (i.e., Age groups, Indigenous status, socio-economic disadvantages) and clinical characteristics (i.e., comorbidity, cancer morphology, location of tumor, tumor resection, palliative care).
Our findings highlight the significant economic burden of pancreatic cancer on the healthcare system, especially within the first year. Targeted strategies are essential to optimize healthcare delivery, ensure equitable access, and improve outcomes.
量化澳大利亚昆士兰州卫生系统在胰腺癌患者确诊后的头三年内，因住院治疗和急诊科就诊所产生的费用。
我们使用一个链接的行政数据集CancerCostMod，该数据集包括昆士兰癌症登记处（2011年7月1日至2015年6月30日）的癌症诊断信息，以及链接的昆士兰卫生住院患者数据收集和急诊科信息系统记录（2011年7月1日至2018年6月30日），评估了被诊断为原发性胰腺癌（国际疾病分类，第10版：C25）的成年人的费用。费用（以澳元计）使用相关年份的国家公共费用和私立医院收费数据集进行分配。进行描述性分析以评估医院和急诊科的利用率及费用。使用Kruskal-Wallis或Mann-Whitney U检验评估社会人口统计学和临床特征方面的费用差异。
在2082名被诊断为胰腺癌的患者中，确诊后头三年内的住院治疗（n = 26405）总费用为1.007亿澳元；每位患者的中位费用为36832澳元。对于急诊科就诊（n = 4228），相应数字分别为360万澳元（总计）和963澳元（每位患者中位费用）。医院总费用的大部分（81%）和急诊科费用的大部分（79%）发生在确诊后的第一年。存活时间≤6个月的患者每位患者的中位费用最低，但占医院总费用的38%。每位患者的中位费用因社会人口统计学（即年龄组、原住民身份、社会经济劣势）和临床特征（即合并症、癌症形态学、肿瘤位置、肿瘤切除、姑息治疗）而有很大差异。
我们的研究结果凸显了胰腺癌给医疗系统带来的巨大经济负担，尤其是在第一年。有针对性的策略对于优化医疗服务提供、确保公平可及性以及改善治疗效果至关重要。
