Impact of initial pattern of care on hospital costs in a cohort of incident lung cancer cases.
OBJECTIVE
Lung cancer is a disease with high consumption of health care resources. The aim of this study was to describe hospital costs due to lung cancer care from diagnosis until death or end of the study follow-up, in a cohort of incident cases, by using administrative data.


METHODS
Particular attention was given to the determinants of total costs and the impact of the initial treatment approach on the process of costs accumulation. Incident cases were identified by the local Cancer Registry (January 2000-December 2003) among the residents of Turin (Italy). Per patient hospital care has been determined from administrative databases (outpatient radiotherapy records and hospital discharge records). Costs determinants were identified via a multivariable generalized linear model (GLM), with a Gamma cost distribution and a logarithmic link function. To assess the time effect over the cost accumulation process for non-small-cell lung cancer cases, the same GLM Gamma model was repeated at different follow-up periods. Analyses were stratified by cancer histotype.


RESULTS
Results evidenced the relevant role of initial patterns of care on the cost accumulation process, with increased midterm costs associated with curative patterns of care.


CONCLUSIONS
The use of administrative data enabled hospital lung cancer care to be described, and related costs to be estimated.
Unit of Cancer Epidemiology, AOU S. Giovanni Battista, CPO-Piemonte, CERMS and University of Turin, Turin, Italy. evapagano@yahoo.com
Eva
E
Pagano
Dario
D
Gregori
Claudia
C
Filippini
Daniela
D
Di Cuonzo
Enrico
E
Ruffini
Roberto
R
Zanetti
Stefano
S
Rosso
Oscar
O
Bertetto
Franco
F
Merletti
Giovannino
G
Ciccone
D000368:Aged; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D015233:Models, Statistical; D012042:Registries; D018709:Statistics, Nonparametric; D015996:Survival Rate