Abstract
BackgroundThere is currently no active surveillance of metastatic and non-malignant brain tumours in Canada as well as data on the health service use of children and youth with brain tumours. The objective of this study was to identify pediatric primary, metastatic, benign, and unspecified brain tumours in Ontario, Canada and to describe their health service use from a population based perspective.MethodsThe population based healthcare administrative databases National Ambulatory Care Reporting System and the Discharge Database were used. Patients with malignant (primary and metastatic), benign, and unspecified brain tumours in acute care between fiscal year 2003/04 and 2009/10 were identified using specified International Classification of Diseases version ten codes.ResultsBetween fiscal year 2003/04 and 2009/10, there were 4022 brain tumour episodes of care (18.4 per 100,000 children and youth). Malignant brain tumors had the highest rates of episodes of care (14.9 times higher than that of benign and 5.7 times higher than that of unspecified brain tumours). Compared to patients with malignant brain tumours, those with benign brain tumours spent a longer period of time in acute care (p < .05) and patients with unspecified brain tumours stayed in the intensive care units for a longer period of time (p < .0001) with a lower proportion were discharged home (p < .0001).ConclusionDespite higher rates of malignant brain tumour episodes of care, patients with benign and unspecified brain tumours also use acute care services and post-acute services that are currently not taken into account in healthcare planning and resource allocation. Active surveillance and research of metastatic and non-malignant brain tumours that can inform the planning of healthcare services and resource allocation for this population is encouraged.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-2016-0) contains supplementary material, which is available to authorized users.
Highlights
There is currently no active surveillance of metastatic and non-malignant brain tumours in Canada as well as data on the health service use of children and youth with brain tumours
During this 7-year period, the rate of brain tumour episodes of care remained relatively steady, the rate among males fluctuated while the rate among females decreased from fiscal years 2003/04 to 2005/ 06 and increased from 2006/07 to 2009/10 (Fig. 1 and Additional file 1)
The rates of malignant brain tumour episodes of care decreased from fiscal years 2003/04 to 2007/08, after which it increased to rates seen in 2003/ 04 (Fig. 2 and Additional file 1)
Summary
There is currently no active surveillance of metastatic and non-malignant brain tumours in Canada as well as data on the health service use of children and youth with brain tumours. The objective of this study was to identify pediatric primary, metastatic, benign, and unspecified brain tumours in Ontario, Canada and to describe their health service use from a population based perspective. A population based perspective on children and youth with brain tumours Brain tumours can be malignant (primary and metastatic) or non-malignant. Non-malignant brain tumours (i.e., benign) do not contain cancer cells, are generally slow-growing, have well-defined borders, and do not invade surrounding tissue while malignant brain tumours are cancerous, fast growing, and can invade surrounding tissue and structures [3]. There is no such data on the number and health service use of pediatric patients with brain tumours in Ontario, Canada, even though primary brain In Canada between 2000 and 2001, brain tumours accounted for $98.4 million in direct costs and $805.1 million in indirect costs and compared to all patients in Canada, those with primary brain tumours had longer median length of stay in acute care and higher readmission rates at one week and 1 month post-discharge [4].
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