Reported cancer spending in relation to population characteristics, disease burden and service activity for primary care trusts in South East England.
BACKGROUND
Since 2000 English cancer policy has directed extra funding towards improving cancer outcomes and quality of care. Few evaluations have related programme budget data on cancer spending to population differences, disease burden, outcome or service activity for cancer. We used existing routine data to explore these associations for 39 primary care trusts (PCTs) in South East England in 2005-2007.


METHODS
We plotted the cancer spending reported by PCTs in pounds per 100 000 population against measures of population characteristics, disease burden and treatment and hospital activity. We explored associations with PCT size, deprivation, age-standardized cancer incidence and mortality rates, proportions treated with surgery, radiotherapy and chemotherapy and per capita bed days.


RESULTS
Lower per capita spending on cancer was associated with smaller PCT populations and a higher proportion of deprived areas within them. Higher spending was associated with higher proportions of radiotherapy treatment and higher per capita hospital bed days for cancer.


CONCLUSIONS
Cancer spending reported by South East England PCTs does not appear to be related to disease burden, but may relate to treatment and service activity. Models are required to relate possible effects of different expenditures and interventions to improve population outcomes for cancer.
King's College London, Thames Cancer Registry, 1st Floor, Capital House, London SE1 3QD, UK. catherine.okello@kcl.ac.uk
Catherine
C
Okello
Henrik
H
Møller
Elizabeth A
EA
Davies
D017281:Cost of Illness; D004739:England / Q000453:epidemiology; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D009369:Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy; D011320:Primary Health Care / Q000191:economics*; D012042:Registries