title: Factors affecting hospital costs in lung cancer patients in the United Kingdom.
abstract: Rising healthcare costs and financial constraints are increasing pressure on healthcare budgets. There is little published data on the healthcare costs of lung cancer in the UK, with international studies mostly small and limited by data collection methods. Accurate assessment of healthcare costs is essential for effective service planning.
  
  
  
  We conducted a retrospective, descriptive cohort study linking clinical data from a local electronic database of lung cancer patients at a large UK teaching hospital with recorded hospital income. Costs were adjusted to 2013-2014 prices.
  
  
  
  The study analysed secondary care costs of 3274 patients. Mean cumulative costs were £5852 (95% CI, £5694 to £6027) at 90 days and £10,009 (95% CI, £9717 to £10,278) at one year. The majority of costs (58.5%) were accumulated within the first 90 days, with acute inpatient costs the largest contributor at one year (42.1%). The strongest predictor of costs was active treatment, especially surgery. Costs were also affected by age, route to diagnosis, clinical stage and cell type.
  
  
  
  Successful early diagnosis initiatives that increase radical treatment rates and improve outcomes may significantly increase the secondary care costs of lung cancer management. The use of routine NHS clinical and financial data can enable efficient and effective analyses of large cohort health economic data.
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK. Electronic address: martyn.kennedy@nhs.net.
authors.forename: Martyn P T
authors.initials: MP
authors.lastname: Kennedy
authors.affiliation: Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Crewe Road South, EH4 2XR, UK.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hall
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds, LS9 7TF, UK.
authors.forename: Matthew E J
authors.initials: ME
authors.lastname: Callister
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000379:methods; D003695:Delivery of Health Care / Q000191:economics*; D055088:Early Detection of Cancer / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000191:economics* / Q000473:pathology / Q000601:surgery; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D063127:Secondary Health Care / Q000191:economics / Q000706:statistics & numerical data; D013534:Survival; D006113:United Kingdom
keywords: Cancer; Costs; Health economics; Informatics; Lung cancer