Abstract
BackgroundBladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers. The objective of this study was to characterize the use of health-care services and costs associated with BC among patients who underwent radical cystectomy (RC) in the province of Quebec.MethodsWe conducted a descriptive study in a retrospective cohort of patients who underwent RC for BC between 2000 and 2009. Data was obtained from two health administrative databases (RAMQ and ISQ). We calculated average costs per patient and total costs in 2014 Canadian dollars for the following components of costs: 1) Pre-surgery costs (pre and post-urologist consultations, urologist consultations, cystoscopies, TURBTs, imaging procedures); 2) Costs of radical cystectomy and 3) Post-surgery costs (urologist consultations, post-operative consultations, medical oncologist consultations, imaging procedures and post-operative complication management). ARIMA models were used to evaluate trends in average costs per patient over the study period.ResultsAmong 2759 patients included in the study (75 % men), average pre-surgery costs, RC costs, and post-surgery costs were estimated at 3762$, 18979$ and 4770$, respectively. RC cost was responsible for 69 % of total costs, followed by post-operative consultations (7.8 %), post-operative complications and TURBTs (6 % of total costs, each). Academic hospitals performed RC at a lower average cost, compared to community hospitals (difference of $1000, p < .0001). A decreased trend in post-surgery costs was detected in the year 2009.ConclusionsCosts of RC, TURBT, consultations and post-operative complications were the most important economic components of total RC cost per patient in Quebec. Academic hospitals performed RC at a lower cost, compared to community hospitals.
Highlights
Bladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers
Data source The cohort was built with the linkage of two provincial health administrative databases: the medical billing records database of the Régie de l’assurance maladie du Québec (RAMQ), and the Fichier des évenements démographiques de l’Institut de la statistique du Québec (ISQ)
We analyzed a cohort formed by 2759 patients who underwent radical cystectomy (RC) for BC and with medical services data available for the four months period before RC (75 % were men)
Summary
Bladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers. The objective of this study was to characterize the use of health-care services and costs associated with BC among patients who underwent radical cystectomy (RC) in the province of Quebec. Bladder cancer (BC) has the highest lifetime treatment costs per patient of all cancers, from diagnosis to death [1, 2]. There is a lack of studies on the trajectories of BC patients in the continuum of care with respect to costs and the use of medical services [8]. The objective of the present study was to describe health-care utilization and associated costs among patients who underwent RC for BC in the province of Quebec - Canada, as from the public healthcare system perspective
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