title: Lung Cancer in Homeless People: Clinical Outcomes and Cost Analysis in a Single Institute.
abstract: Introduction. To characterize the demographic and clinical features, outcomes, and treatment costs of lung cancer in homeless people. Methods. Medical records of 22 homeless patients with lung cancer at Seoul National University Boramae Medical Center in Seoul, South Korea, were retrospectively analyzed. Results. All patients were men (median age, 62 years). Most patients (78%) had advanced disease (stage IIIB, n = 2; stage IV, n = 15). Seven died during initial hospitalization (median survival, 1.5 months). Six were lost to follow-up after initial outpatient visits or discharges from initial admission (median follow-up, 13 days). Only 4 received appropriate treatment for their disease and survived for 1, 15, 19, and 28 months, respectively. Conversely, 4 of 5 patients with early stage disease (stage I, n = 4; stage IIA, n = 1) received curative surgery (median follow-up 25.5 months). The median treatment cost based on 29 days of hospitalization and 2 outpatient visits was $12,513, constituting 47.3% of the 2013 per capita income. Inpatient treatment accounted for 90% of the total costs. The National Health Insurance Service paid 82% of the costs. Conclusion. Among the homeless, lung cancer seems to be associated with poor prognosis and substantial costs during a relatively short follow-up and survival period.
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Koung Jin
authors.initials: KJ
authors.lastname: Suh
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Jin Hyun
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Jin-Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: In Sil
authors.identifier: 0000-0002-8494-584X
authors.initials: IS
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies