Abstract
ObjectiveWith the increasing complexity of oncological therapy, the number of inpatient admissions to radiotherapy and non-radiotherapy departments might have changed. In this study, we aim to quantify the number of inpatient cases and the number of radiotherapy fractions delivered under inpatient conditions in radiotherapy and non-radiotherapy departments.MethodsThe analysis is founded on data of all hospitalized cases in Germany based on Diagnosis-Related Group Statistics (G-DRG Statistics, delivered by the Research Data Centers of the Federal Statistical Office). The dataset includes information on the main diagnosis of cases (rather than patients) and the performed procedures during hospitalization based on claims of reimbursement. We used linear regression models to analyze temporal trends. The considered data encompass the period from 2008 to 2017.ResultsOverall, the number of patients treated with radiotherapy as inpatients remained constant between 2008 (N = 90,952) and 2017 (N = 88,998). Starting in January 2008, 48.9% of 4000 monthly cases received their treatment solely in a radiation oncology department. This figure decreased to 43.7% of 2971 monthly cases in October 2017. We found a stepwise decrease between December 2011 and January 2012 amounting to 4.3%. Fractions received in radiotherapy departments decreased slightly by 29.3 (95% CI: 14.0–44.5) fractions per month. The number of days hospitalized in radiotherapy departments decreased by 83.4 (95% CI: 59.7, 107.0) days per month, starting from a total of 64,842 days in January 2008 to 41,254 days in 2017. Days per case decreased from 16.2 in January 2008 to 13.9 days in October 2017.ConclusionOur data give evidence to the notion that radiotherapy remains a discipline with an important inpatient component. Respecting reimbursement measures and despite older patients with more comorbidities, radiotherapy institutions could sustain a constant number of cases with limited temporal shifts.
Highlights
Cancer remains a major health care problem in Europe, with an estimated number of 3.2 million new cases and 1.7 million deaths per year in an ageing population [1, 2].Radiotherapy is a cornerstone of modern cancer therapy, with half of all cancer patients in Europe receiving radiotherapy at least once [3]
We found a linear decrease in case numbers across the observational period in all cases with radiotherapy considering all departments. This was not true when radiochemotherapy was administered, where we found a trend for an increase in case numbers (0.8 cases per month, 95% confidence intervals (CI): 0.1–1.6; Table 2)
The relative decline was most pronounced in the subgroup of cases with radiochemotherapy treated in radiotherapy departments alone (–0.16% per month; 95% CI: –0.2, –0.12)
Summary
Cancer remains a major health care problem in Europe, with an estimated number of 3.2 million new cases and 1.7 million deaths per year in an ageing population [1, 2].Radiotherapy is a cornerstone of modern cancer therapy, with half of all cancer patients in Europe receiving radiotherapy at least once [3]. Cancer remains a major health care problem in Europe, with an estimated number of 3.2 million new cases and 1.7 million deaths per year in an ageing population [1, 2]. The application of radiotherapy has different objectives, aimed at curative treatment, local control, or palliation [4]. It is one of the most cost-effective cancer treatments and used differently in the different European countries [5]. Germany has the highest number of radiotherapy centers (n = 289) in Europe, followed by France (n = 177) and Italy (n = 172) [3, 6]. Borras et al calculated that the demand for radiation treatment in Europe
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