Cross-country comparisons of health-care costs: the case of cancer treatment in the Nordic countries.
The objective of this study is to perform a cross-country comparison of cancer treatment costs in the Nordic countries, and to demonstrate the added value of decomposing documented costs in interpreting national differences. The study is based on individual-level data from national patient and prescription drug registers, and data on cancer prevalence from the NORDCAN database. Hospital costs were estimated on the basis of information on diagnosis-related groups (DRG) cost weights and national unit costs. Differences in per capita costs were decomposed into two stages: stage one separated the price and volume components, and stage two decomposed the volume component, relating the level of activity to service needs and availability. Differences in the per capita costs of cancer treatment between the Nordic countries may be as much as 30 per cent. National differences in the costs of treatment mirror observed differences in total health care costs. Differences in health care costs between countries may relate to different sources of variation with different policy implications. Comparisons of per capita spending alone can be misleading if the purpose is to evaluate, for example, differences in service provision and utilisation. The decomposition analysis helps to identify the relative influence of differences in the prevalence of cancer, service utilisation and productivity.
Department of Health Research, SINTEF Technology and Society, Trondheim, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: jorid.kalseth@sintef.no.
Jorid
J
Kalseth
Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.
Thomas
T
Halvorsen
Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.
Birgitte
B
Kalseth
Department of Health Research, SINTEF Technology and Society, Trondheim, Norway.
Kjartan
K
Sarheim Anthun
National Institute for Health and Welfare (THL), Helsinki, Finland.
Mikko
M
Peltola
National Institute for Health and Welfare (THL), Helsinki, Finland.
Kirsi
K
Kautiainen
National Institute for Health and Welfare (THL), Helsinki, Finland.
Unto
U
Häkkinen
Karolinska Institutet (KI), Solna, Sweden.
Emma
E
Medin
Karolinska Institutet (KI), Solna, Sweden.
Jonatan
J
Lundgren
Karolinska Institutet (KI), Solna, Sweden.
Clas
C
Rehnberg
Landspítali-National University Hospital of Iceland, Reykjavik, Iceland.
Birna Björg
BB
Másdóttir
Landspítali-National University Hospital of Iceland, Reykjavik, Iceland.
Maria
M
Heimisdottir
Landspítali-National University Hospital of Iceland, Reykjavik, Iceland.
Helga Hrefna
HH
Bjarnadóttir
Ministry of Health Affairs, Tórshavn, Faroe Islands.
Jóanis Erik
JE
Køtlum
Danish Institute for Health Services Research (DSI), Copenhagen, Denmark.
Janni
J
Kilsmark
Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Central Norway Regional Health Authority, Stjørdal, Norway.
Vidar
V
Halsteinli
D003718:Denmark / Q000453:epidemiology; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D005387:Finland / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D013548:Sweden / Q000453:epidemiology
Cancer treatment; Health-care costs; National comparisons