title: The economic burden of gynecologic cancers in California, 1998.
abstract: OBJECTIVE
  Our aim was to estimate the direct and indirect costs of gynecologic cancers including cervical, ovarian, and uterine cancer in California in 1998.
  
  
  METHODS
  Hospitalization costs, including costs of primary and secondary diagnoses of each of the gynecologic cancers, are derived from the California Patient Discharge dataset. Charges are converted to costs using hospital-specific cost-to-charge ratios and an imputed cost for HMO hospitalizations. Other direct medical costs are derived from the 1997 Medical Expenditure Panel Survey. Indirect mortality costs are the product of the number of deaths and the expected value of a female's future earnings, including an imputed value of housekeeping services.
  
  
  RESULTS
  The total cost of the three gynecologic cancers in California is estimated at $624 million for 1998. Indirect costs or losses in productivity due to premature death are twice the direct medical care costs. Hospitalization inpatient costs account for more than half of total direct costs for each of these cancers. Total costs for ovarian cancer are highest among the three cancers.
  
  
  CONCLUSIONS
  The estimates presented here highlight the need for studies that identify cost-effective screening methods and the relationship between treatment protocols and outcomes. The methods presented here could be used to develop stage- or treatment-specific costs that would be useful for such analyses. Only through early detection and more effective management of gynecologic cancers can there be a reduction in the morbidity, premature death, and high costs of cervical, ovarian, and uterine cancers.
authors.affiliation: Institute for Health and Aging, School of Nursing, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, USA. wmax@itsa.ucsf.edu
authors.forename: Wendy
authors.initials: W
authors.lastname: Max
authors.forename: Dorothy P
authors.initials: DP
authors.lastname: Rice
authors.forename: Hai-Yen
authors.initials: HY
authors.lastname: Sung
authors.forename: Martha
authors.initials: M
authors.lastname: Michel
authors.forename: Wendy
authors.initials: W
authors.lastname: Breuer
authors.forename: Xiulan
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics; D005260:Female; D005833:Genital Neoplasms, Female / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D017048:Health Care Costs / Q000706:statistics & numerical data; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged